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Tube dysfunction following percutaneous endoscopic gastrostomy and jejunostomy
H C Wolfsen1, R A Kozarek, T J Ball
1Section of Therapeutic Endoscopy, Virginia Mason Clinic, Seattle, Washington 98101.
Gastrointestinal Endoscopy
|May 1, 1990
Summary
Percutaneous endoscopic jejunostomy (PEJ) tubes show higher dysfunction rates and do not prevent aspiration, unlike percutaneous endoscopic gastrostomy (PEG) tubes. PEJ is not routinely recommended for tube feeding due to these complications.
Area of Science:
- Gastroenterology
- Medical Devices
- Patient Safety
Background:
- Percutaneous endoscopic gastrostomy (PEG) and jejunostomy (PEJ) tubes are common alternatives to surgical feeding tube placement.
- Previous studies suggested PEJ tubes offer benefits like reduced reflux and aspiration prevention.
Purpose of the Study:
- To compare the incidence of tube dysfunction, replacement, removal, and aspiration between PEG and PEJ tubes.
- To evaluate the efficacy of PEJ tubes in preventing aspiration and reducing complications.
Main Methods:
- Retrospective review of 191 patients who received either PEG or PEJ tube placement.
- Data collection focused on tube dysfunction (leakage, plugging, fracture, migration), need for replacement/removal, and aspiration events.
Main Results:
- Tube dysfunction occurred in 36% of patients, with significantly higher rates and need for replacement in PEJ patients.
- 30-day complications, including tube removal and aspiration, were more frequent in PEJ recipients compared to PEG recipients.
- PEJ placement did not demonstrate a significant advantage in preventing aspiration.
Conclusions:
- PEJ tubes exhibit a higher incidence of dysfunction and complications compared to PEG tubes.
- The purported benefits of PEJ for aspiration prevention were not supported by this study's findings.
- Routine PEJ placement is not indicated for patients requiring enteral nutrition due to increased risks.