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Related Experiment Videos

A reproducible, safe jejunostomy replacement technique by a percutaneous endoscopic method.

S H Westfall1, C H Andrus, K S Naunheim

  • 1Department of Surgery, University Hospital, St. Louis University Medical Center, Missouri 63110-0250.

The American Surgeon
|March 1, 1990
PubMed
Summary

This study presents a new technique for jejunostomy tube replacement after esophagogastrectomy. Direct percutaneous endoscopic jejunostomy (PEJ) offers an easier, reproducible method avoiding repeat laparotomy for nutritional support.

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Area of Science:

  • Gastroenterology
  • Surgical Innovation
  • Oncology

Background:

  • Patients undergoing esophagogastrectomy for cancer require nutritional support.
  • Operative jejunostomy tubes are often placed during surgery but may need replacement if removed.
  • Previous jejunostomy replacement necessitated repeat laparotomy.

Purpose of the Study:

  • To describe a novel technique for jejunostomy tube replacement.
  • To evaluate the feasibility of direct percutaneous endoscopic jejunostomy (PEJ) placement in patients post-esophagogastrectomy.

Main Methods:

  • A direct percutaneous endoscopic jejunostomy (PEJ) technique was employed.
  • A #16-Fr, Pezzer-type Ponsky tube was used for placement.
  • The procedure was performed in two patients who had their original jejunostomy tubes removed post-esophagogastrectomy.

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Main Results:

  • The described PEJ placement technique was successfully used in two patients.
  • The method proved to be easy and reproducible.
  • The fibrosed tract facilitated safe endoscopic identification and tube placement.

Conclusions:

  • Direct percutaneous endoscopic jejunostomy (PEJ) is a viable and effective method for replacing operative jejunostomy tubes.
  • This technique avoids the need for repeat laparotomy, simplifying postoperative care.
  • PEJ offers a reproducible approach for nutritional support in patients following esophagogastrectomy.