Direct percutaneous endoscopic jejunostomy - Should we move on to single- and double-balloon enteroscopy techniques?

Area of Science:

• Gastroenterology
• Minimally Invasive Surgery

Background:

• Direct percutaneous endoscopic jejunostomy (DPEJ) is an endoscopic technique for jejunal access.
• It is indicated for enteral nutrition when gastric access is not feasible.
• It is also used for jejunal decompression in malignant small bowel obstruction.

Discussion:

• The procedure involves advancing a colonoscope or enteroscope deep into the jejunum.
• The feeding tube insertion follows the established Ponsky-Gauderer method, similar to gastrostomy tube placement.
• This method provides a minimally invasive option for jejunal interventions.

Key Insights:

• DPEJ enables crucial enteral nutrition delivery bypassing the stomach.
• It provides effective decompression for malignant small bowel obstruction.
• The technique leverages existing endoscopic expertise and methods.

Outlook:

• Further research may refine DPEJ techniques for broader applications.
• Exploring DPEJ in complex pediatric cases could expand its utility.
• Standardization of DPEJ procedures may enhance patient outcomes.