Enteral Access by Double-Balloon Enteroscopy: An Alternative Method of Direct Percutaneous Endoscopic Jejunostomy Placement

Despott, Edward J.; Gabe, Simon; Tripoli, Eric; Konieczko, Krysia; Fraser, Chris

doi:10.1007/s10620-010-1306-2

Cited by 38 publications

(34 citation statements)

References 24 publications

(40 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Thus, we hypothesized that DBE would allow successful feeding tube placement in patients in whom attempted conventional DPEJ placement with colonoscopies had failed. Although DBE-assisted DPEJ has been described, 10,11 no patients in these reports experienced failure of attempted conventional DPEJ; thus, a benefit of DBE over colonoscopes was not confirmed. In our study, we targeted a difficult patient cohort-patients in whom DPEJ had failed with the use of variable-stiffness colonoscopes, which have been shown to provide greater insertion depth than dedicated push enteroscopes, 12 -and showed the benefit of DBE for DPEJ placement.…”

Section: Discussionmentioning

confidence: 96%

Double-balloon enteroscopy as a rescue technique for failed direct percutaneous endoscopic jejunostomy when using conventional push enteroscopy (with video)

Song

Baron

Saleem

et al. 2012

Gastrointestinal Endoscopy

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 96%

Double-balloon enteroscopy as a rescue technique for failed direct percutaneous endoscopic jejunostomy when using conventional push enteroscopy (with video)

Song

Baron

Saleem

et al. 2012

Gastrointestinal Endoscopy

View full text Add to dashboard Cite

“…DBE is a relatively recent endoscopic modality, which enables high-resolution imaging of the entire small bowel, allowing interventional endotherapy such as hemostasis, snare polypectomy, pneumatic balloon stricture dilation, and stent placement, among others [3,5,11,12,13,14,15,16]. It is quite clear that this technology has a direct therapeutic advantage over other investigational methods such as capsule endoscopy or magnetic resonance imaging enteroclysis.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic Double-Balloon Enteroscopy: A Binational, Three-Center Experience

Jovanović¹,

Vormbrock²,

Zimmermann

et al. 2011

Dig Dis

View full text Add to dashboard Cite

Background/Aims: There are few reports focusing on therapeutic small bowel endoscopy. The aim of this study was to analyze the results of therapeutic small bowel endoscopy in a large cohort of patients. Methods: A retrospective study of a prospectively collected database comprising all patients undergoing diagnostic and therapeutic small bowel endoscopy in three centers. Results: A total of 614 double-balloon enteroscopies were performed in 534 patients. The most common pathological findings were angiodysplasias and vascular lesions (n = 98, 18%), mucosal ulcers and erosions (n = 95, 17.8%), polyps and tumors (including patients with familiar polyposis syndrome such as Peutz-Jeghers syndrome, familiar adenomatous polyps syndrome, neurofibromatosis, adenocarcinoma, neuroendocrine tumors and gastrointestinal stromal tumors) (n = 52, 9.7%), and strictures (Crohn’s disease, ischemia, tumors) (n = 12, 2.2%). The mean duration of therapeutic small bowel enteroscopy was 67 min (range 30–115) compared to 50 min (range 25–105) for diagnostic procedures (p < 0.05). A therapeutic small bowel endoscopy was performed in 121 patients (22%). Therapeutic procedures included argon plasma coagulation of vascular lesions (n = 73), polypectomy (n = 49), mucosectomy (n = 5), stricture dilation (n = 7), foreign body extraction (n = 7), injection of fibrin glue (n = 10), and clip placement (n = 5). There were a total of 5 complications (0.9%; paralytic ileus, n = 2, pancreatitis, n = 1, bleeding n = 2). No perforations or deaths occurred. Conclusion: Endoscopists performing double-balloon enteroscopy should be trained and prepared to provide therapeutic interventions for small bowel disorders including argon plasma coagulation, injection, hemoclipping, polypectomy, mucosectomy and foreign body extraction. Therapeutic small bowel endoscopy, albeit associated with complications in about 1% of cases, can be considered a relatively safe procedure.

show abstract

“…This procedure may be carried out with adult or pediatric endoscopes via a percutaneous gastrostomy orifice or with push enteroscopes or balloon-assisted enteroscopes. Several techniques have been described, such as the "T" pexies triangulation system, magnetic jejunal anchors, and overtube maintenance during bumper pulling or with fluoroscopy guidance (8)(9)(10)(11)(12)(13)(14)(15). In spite of all different approaches, DPEJ is considered to be a technically difficult procedure with success rates ranging from 68% to 100% (3,16).…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2017

View full text Add to dashboard Cite

Background: Direct percutaneous endoscopic jejunostomy (DPEJ) is a useful method to provide enteral nutrition to individuals when gastric feeding is not possible or contraindicated. The aim of this study was to analyze the efficacy and safety of DPEJ tube placement with the Gauderer-Ponsky technique by the pull method, using single-balloon enteroscopy (SBE) without fluoroscopy.Methods: This is a retrospective analysis of patients undergoing SBE for DPEJ placement in a referral hospital between January 2010 and March 2016. Technical success, clinical success and procedure related complications were recorded.Results: Twenty-three patients were included (17 males, median age 71 years, range 37-93 years). The most frequent indications for DPEJ were gastroesophageal cancer (n = 10) and neurological disease (n = 8). Eighty-seven percent of the patients had a contraindication to percutaneous endoscopic gastrostomy (PEG) and PEG was unsuccessful in the remaining patients. The technical success rate was 83% (19/23), transillumination was not possible in three patients and an accidental exteriorization of the bumper resulting in a jejunal perforation occurred in one patient. The clinical success was 100% (19/19). The median follow-up was five months (range 1-35 months). Apart from the case of jejunal perforation and the two cases of accidental exteriorization, there were no other complications during follow-up. The 6-month survival was 65.8% and the 1-year survival was 49.3%.Conclusion: DPEJ can be carried out successfully via SBE without fluoroscopy with a low rate of significant adverse events. Although, leaving the overtube in place during the bumper pulling can be useful for distal jejunal loops, it can be safely removed in proximal loops to minimize complications.

show abstract

Enteral Access by Double-Balloon Enteroscopy: An Alternative Method of Direct Percutaneous Endoscopic Jejunostomy Placement

Cited by 38 publications

References 24 publications

Double-balloon enteroscopy as a rescue technique for failed direct percutaneous endoscopic jejunostomy when using conventional push enteroscopy (with video)

Double-balloon enteroscopy as a rescue technique for failed direct percutaneous endoscopic jejunostomy when using conventional push enteroscopy (with video)

Therapeutic Double-Balloon Enteroscopy: A Binational, Three-Center Experience

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

Contact Info

Product

Resources

About