Outcomes of double-balloon enteroscopy-assisted direct percutaneous endoscopic jejunostomy tube placement

In this narrative review, invited by the Editors of Gastroenterology, we summarize recent advances in the field of gastrointestinal endoscopy. We have chosen articles published primarily in the past 2-3 years. Although a thorough literature review was performed for each topic, the nature of the article is subjective and systematic and is based on the authors' experience and expertise regarding articles we believed were most likely to be of high clinical and scientific importance.

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“…The most common indication for using double-balloon enteroscopy was the presence of gastroparesis. 95…”

Section: Enteral Nutritionmentioning

confidence: 99%

Recent Advances in Endoscopy

et al. 2017

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“…49 With DBE, a technical success rate of 93 to 100% has been reported, with the 93% rate being in one of the largest reported series with 94 patients. 50,51 Advocates of balloon enteroscopy tout its overall slightly higher technical success rate but the equipment or appropriately trained personnel are not available in many hospitals. A brief overview of SBE and DBE is described well by Chauhan et al in a recent publication for your reference.…”

Section: Direct Percutaneous Endoscopic Jejunostomy Tubementioning

confidence: 99%

Endoscopic Feeding Access

McCormack

Tariq

2018

Dig Dis Interv

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The need for enteral access for nutritional support has become increasingly important. It is estimated up to a third of hospitalized patients will suffer from malnourishment. There is evidence that enteral is preferable over parenteral nutrition for improved outcomes. Various approaches for enteral access exist today including blind placement of enteral catheters, radiographically, and surgically placed catheters. However, the endoscopic approach for enteral access is a well-established, reliable, safe, and quick method of obtaining enteral access. In this review article, we will cover the various endoscopic approaches for enteral access. We believe there is no single best approach for enteral access and that it should be tailored to the individual patient. This article will cover both temporary options such as nasoenteric catheters and more permanent options such as percutaneous endoscopic stomas (gastrostomy, gastrojejunostomy, direct jejunostomy) and describe their techniques, indications, contraindications, and pitfalls. Additionally, with the rise of weight loss surgery, we will cover how to manage the patient with altered gastrointestinal anatomy. Lastly, we will also review difficult post procedure scenarios associated with all of these endoscopic methods for enteral access and how to either prevent or properly manage them.

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“…The success rate of single-or double-balloon-assisted DPEJ was recently reported to be more than 90%, higher than the past. 8,9 Although several researchers reported techniques for placement and short-term outcomes of DPEJ, little is known about long-term outcomes and factors predicting mortality. In the present study, we report the short-and long-term outcomes after DPEJ, including survival analysis, prognostic factors, and cause of death, comparing with those after PEG.…”

Section: Introductionmentioning

confidence: 99%

Prognostic outcomes after direct percutaneous endoscopic jejunostomy in elderly patients: comparison with percutaneous endoscopic gastrostomy

Nishiwaki¹,

Kurobe²,

Baba³

et al. 2021

Gastrointestinal Endoscopy

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Background and Aims: Direct percutaneous endoscopic jejunostomy (DPEJ) is an alternative method of enteral feeding to percutaneous endoscopic gastrostomy (PEG). Although long-term outcomes of PEG have been reported, little is known regarding the outcomes of DPEJ.Methods: A retrospective cohort study was conducted including 115 and 651 consecutive attempts of DPEJ and PEG, respectively, in a total of 766 elderly patients between April 2004 and March 2019. Patients' clinical background, procedural and long-term outcomes, survival analysis, and cause of death were analyzed.Results: Successful placement rates were 93.9% and 97.1% for DPEJ and PEG, respectively. There was no significant difference in procedure-related adverse events (AEs) between the DPEJ and PEG groups. Rates of pneumonia, vomiting, and upper GI bleeding were significantly lower, whereas those of fistula enlargement and ileus were significantly higher in the DPEJ group as long-term AEs. The median survival periods were 694 and 734 days for DPEJ and PEG, respectively, with no significant differences between the 2 groups. Multivariate analysis revealed that age 80 years old or older, C-reactive protein level of 1.0 mg/dL or higher, and the presence of diabetes were independent risk factors for mortality after DPEJ. Respiratory tract infection was the primary cause of death in both groups.Conclusions: DPEJ is considered a safe and feasible method of access for enteral feeding as well as PEG. Although the survival period after DPEJ may be expected to be as long as that with PEG, DPEJ-specific AEs should be kept in mind on long-term feeding.

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Outcomes of double-balloon enteroscopy-assisted direct percutaneous endoscopic jejunostomy tube placement

Abstract: Compared with the published outcomes of DPEJ by conventional endoscopy, DBE-DPEJ tube placement was technically successful in a high proportion of patients (93 %) and with a relatively low rate of significant adverse events.

Cited by 18 publications

References 15 publications

Recent Advances in Endoscopy

Recent Advances in Endoscopy

Endoscopic Feeding Access

Prognostic outcomes after direct percutaneous endoscopic jejunostomy in elderly patients: comparison with percutaneous endoscopic gastrostomy

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