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Updated: May 25, 2026
10:09
Application of Simplified Stent-bridging Pancreaticogastrostomy in Open Pancreaticoduodenectomy
Published on: March 17, 2026
Current considerations of direct percutaneous endoscopic jejunostomy
Yanfei Zhu1, Liping Shi, Hao Tang
1Department of General Surgery, Nanjing Medical University, Jiangsu, China. zhuyanfei_2002@163.com
Summary
Direct percutaneous endoscopic jejunostomy (DPEJ) offers postpyloric enteral nutrition for patients unable to tolerate gastric feeding. While technically challenging, DPEJ is increasingly used and can be safe and reliable with expertise.
Area of Science:
- Gastroenterology
- Endoscopic Procedures
- Nutritional Support
Background:
- Direct percutaneous endoscopic jejunostomy (DPEJ) is an established method for postpyloric enteral nutrition.
- It is indicated for patients who cannot tolerate gastric feeding.
- However, DPEJ is technically demanding, with reported high failure rates.
Purpose of the Study:
- To describe the current indications for DPEJ.
- To outline the successes and complications associated with DPEJ placement.
- To review the available literature on DPEJ.
Main Methods:
- A comprehensive MEDLINE database search was conducted.
- Keywords included "direct percutaneous endoscopic jejunostomy," "percutaneous endoscopic gastrostomy," and "percutaneous endoscopic gastrostomy with a jejunal extension tube."
- References from key articles were also manually reviewed.
Main Results:
- DPEJ use is increasing for patients unable to tolerate gastric feeding.
- Variations in patient selection and technique influence success rates.
- Common causes of failure include poor transillumination and gastroduodenal obstruction.
- Limited data currently exist on DPEJ's safety and effectiveness.
Conclusions:
- The clinical application of DPEJ is expanding.
- With appropriate expertise and care, DPEJ can be a reliable and safe procedure.
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