Related Experiment Videos
Direct endoscopic percutaneous jejunostomy (EPJ). Clinical results
J Mellert1, M B Naruhn, K E Grund
1Department of Surgery, Eberhard-Karls University of Tübingen, Germany.
Surgical Endoscopy
|August 1, 1994
Summary
Direct endoscopic puncture of the small bowel (EPJ) offers a safe and effective feeding alternative for patients with complex gastrointestinal issues. This minimally invasive technique successfully provided enteral nutrition in 39 patients, avoiding surgical jejunostomy.
Area of Science:
- Gastroenterology
- Endoscopic Procedures
- Surgical Interventions
Background:
- Enteral feeding is crucial for patients with gastrointestinal complications.
- Traditional methods may be unsuitable for patients post-gastrectomy or with complex anatomy.
- Endoscopic access to the small bowel is challenging in specific clinical scenarios.
Purpose of the Study:
- To evaluate the safety and efficacy of direct endoscopic puncture of the small bowel (EPJ).
- To assess direct EPJ as an alternative to surgical catheter-jejunostomy.
- To identify indications and outcomes for direct EPJ.
Main Methods:
- Retrospective review of 39 patients undergoing direct EPJ from January 1990 to June 1992.
- Procedure performed under endoscopic guidance using a string pull-through technique.
- Local anesthesia utilized for bedside insertion of feeding tubes.
Main Results:
- Successful direct EPJ achieved in 39 out of 44 attempted cases (88.6%).
- Indications included malnutrition post-gastrectomy (n=19), anastomotic issues (n=13), esophageal perforation (n=3), fistulas (n=2), and trauma (n=2).
- Complications included tube dysfunction (n=5), enteric ulcers (n=2), and local infections (n=3), managed conservatively.
Conclusions:
- Direct EPJ is a safe and effective minimally invasive alternative to surgical jejunostomy.
- The string pull-through technique facilitates successful tube placement.
- Direct EPJ enables essential postoperative enteral feeding in challenging patient populations.