Percutaneous gastrojejunostomy in children: efficacy and safety

Transgastric jejunal intubation via gastrostomy (GJ) can be indicated when enteral nutrition via gastrostomy is not possible. Between 2001 and 2008, the authors prospectively assessed the outcomes in 29 patients (median age, 10 months) after GJ. Indications for jejunal feeding were severe gastro-oesophageal reflux (n=27) and intestinal dysmotility (n=2). The GJ was successfully placed in 27/29 patients. Complications were: 31 tube dislodgements, 16 obstructions, 7 leakages around the tube, 6 internal balloon ruptures and 1 intussusception. The median lifetime of the tube was 3 months. 9/27 patients died during the study period, 11 patients required surgery, 2 required parenteral nutrition, gastric feeding became tolerated in 3 and the gastrojejunal feeding tube was kept in place in the remaining 2. A transgastric jejunal feeding tube may constitute a transitory alternative to antireflux surgery or prolonged parenteral nutrition. However, the high frequency of complications and tube replacement limits its use.