Direct percutaneous endoscopic jejunostomy using single-balloon enteroscopy without fluoroscopy: a case series

Area of Science:

• Gastroenterology
• Endoscopy
• Surgical Techniques

Background:

• Direct percutaneous endoscopic jejunostomy (DPEJ) provides enteral nutrition when gastric feeding is not possible.
• The Gauderer-Ponsky technique via pull method using single-balloon enteroscopy (SBE) is an alternative approach.
• This study evaluates SBE without fluoroscopy for DPEJ placement.

Purpose of the Study:

• To analyze the efficacy and safety of DPEJ tube placement using SBE without fluoroscopy.
• To assess technical and clinical success rates.
• To identify and report procedure-related complications.

Main Methods:

• Retrospective analysis of patients undergoing SBE for DPEJ placement.
• Data collected from January 2010 to March 2016.
• Evaluation of technical success, clinical success, and complications.

Main Results:

• Twenty-three patients (17 males, median age 71) underwent DPEJ.
• Indications included gastroesophageal cancer (n=10) and neurological disease (n=8).
• Technical success rate was 83% (19/23), with 100% clinical success (19/19). One jejunal perforation occurred. 6-month and 1-year survival rates were 65.8% and 49.3% respectively.

Conclusions:

• DPEJ via SBE without fluoroscopy is a successful procedure with a low rate of significant adverse events.
• The technique is a viable option for enteral nutrition when gastric feeding is contraindicated or unsuccessful.
• Overtube management during bumper pulling can be adjusted to minimize complications.