Direct Percutaneous Endoscopic Jejunostomy: Procedural and Nutrition Outcomes in a Large Patient Cohort

Area of Science:

• Gastroenterology
• Surgical Oncology
• Nutritional Support

Background:

• Direct percutaneous endoscopic jejunostomy (DPEJ) is a critical intervention for enteral nutrition (EN) in specific patient groups.
• Indications include managing postoperative anastomotic leaks after esophagectomy/gastrectomy and preventing aspiration in high-risk individuals.

Purpose of the Study:

• To characterize the indications, technical success, procedural and nutritional outcomes, and adverse events associated with DPEJ insertion.
• To identify predictors of adverse events and procedural success in a large patient cohort.

Main Methods:

• Retrospective analysis of 452 patients undergoing 480 DPEJ insertions between January 2009 and March 2015.
• Data collection from electronic medical records, including demographics, procedural details, and nutritional outcomes.
• Regression analyses to determine factors influencing procedural success and adverse events.

Main Results:

• 83% of DPEJ procedures were technically successful, with 98% of patients initiating feeding.
• Median daily caloric delivery was 1775 calories, with no significant change in median body mass index (BMI) post-procedure.
• Adverse events occurred in 18% of insertions (3% serious); head and neck cancer patients experienced more adverse events than esophageal cancer patients.

Conclusions:

• DPEJ is a successful and safe endoscopic procedure for establishing enteral access.
• It effectively supports nutrition in malnourished patients and those with postoperative upper gastrointestinal cancer.
• The procedure demonstrates a favorable safety profile with manageable adverse events.