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Percutaneous Endoscopic Gastrostomy and Jejunostomy for Feeding

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Diagnostic and Therapeutic Procedures in Gastroenterology

Part of the book series: Clinical Gastroenterology ((CG))

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Abstract

Percutaneous endoscopic feeding tube placement as suggested by its name is an endoscopy-guided artificially created ostomy connecting the gastric cavity and the skin surface. Enteral nutrition has been shown to be superior to parenteral nutrition in improving immunity and nutrition, but enteral access can be a challenge in patients who cannot swallow safely. The need for a percutaneous enteral access arises in patients who are expected to be dependent on tube feeds for a long time, usually for more than 1 month. The most common source of tube feeding is via a nasogastric (NG) or orogastric tube extending into the stomach or naso-jejunal (Dobhoff) tube which extends into the proximal small bowel. The tube is used for delivering tube feeds, water, and medications to the gut. The most common requirements for such a nutritional access are cancers involving upper airways, oral cavity, pharynx, or esophagus; dementia and cerebrovascular accidents with loss of ability to swallow. The procedures performed by gastroenterologists for enteral access include percutaneous endoscopic gastrostomy (PEG), percutaneous endoscopic gastrojejunostomy (PEGJ), and direct percutaneous endoscopic jejunostomy (DPEJ). The most commonly employed technique is the PEG.

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References

  1. Alverdy J, Chi HS, Sheldon GF. The effect of parenteral nutrition on gastrointestinal immunity. The importance of enteral stimulation. Ann Surg. 1985;202(6):681–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Deitch EA, Ma WJ, Ma L, Berg RD, Specian RD. Protein malnutrition predisposes to inflammatory-induced gut-origin septic states. Ann Surg. 1990;211(5):560–7. discussion 7–8

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Gauderer MW, Ponsky JL, Izant RJ Jr. Gastrostomy without laparotomy: a percutaneous endoscopic technique. J Pediatr Surg. 1980;15(6):872–5.

    Article  CAS  PubMed  Google Scholar 

  4. Himal HS, Schumacher S. Endoscopic vs surgical gastrostomy for enteral nutrition. Surg Endosc. 1987;1(1):33–5.

    Article  CAS  PubMed  Google Scholar 

  5. Ljungdahl M, Sundbom M. Complication rate lower after percutaneous endoscopic gastrostomy than after surgical gastrostomy: a prospective, randomized trial. Surg Endosc. 2006;20(8):1248–51.

    Article  CAS  PubMed  Google Scholar 

  6. Jones M, Santanello SA, Falcone RE. Percutaneous endoscopic vs surgical gastrostomy. JPEN J Parenter Enteral Nutr. 1990;14(5):533–4.

    Article  CAS  PubMed  Google Scholar 

  7. Hamidon BB, Abdullah SA, Zawawi MF, Sukumar N, Aminuddin A, Raymond AA. A prospective comparison of percutaneous endoscopic gastrostomy and nasogastric tube feeding in patients with acute dysphagic stroke. Med J Malaysia. 2006;61(1):59–66.

    CAS  PubMed  Google Scholar 

  8. Gomes CA Jr, Lustosa SA, Matos D, Andriolo RB, Waisberg DR, Waisberg J. Percutaneous endoscopic gastrostomy versus nasogastric tube feeding for adults with swallowing disturbances. Cochrane Database Syst Rev. 2012;3:CD008096.

    Google Scholar 

  9. Norton B, Homer-Ward M, Donnelly MT, Long RG, Holmes GK. A randomised prospective comparison of percutaneous endoscopic gastrostomy and nasogastric tube feeding after acute dysphagic stroke. BMJ. 1996;312(7022):13–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Dwolatzky T, Berezovski S, Friedmann R, Paz J, Clarfield AM, Stessman J, Hamburger R, Jaul E, Friedlander Y, Rosin A, Sonnenblick M. A prospective comparison of the use of nasogastric and percutaneous endoscopic gastrostomy tubes for long-term enteral feeding in older people. Clin Nutr. 2001;20(6):535–40.

    Article  CAS  PubMed  Google Scholar 

  11. Park RH, Allison MC, Lang J, Spence E, Morris AJ, Danesh BJ, Russell RI, Mills PR. Randomised comparison of percutaneous endoscopic gastrostomy and nasogastric tube feeding in patients with persisting neurological dysphagia. BMJ. 1992;304(6839):1406–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Segal R, Dan M, Pogoreliuk I, Leibovitz A. Pathogenic colonization of the stomach in enterally fed elderly patients: comparing percutaneous endoscopic gastrostomy with nasogastric tube. J Am Geriatr Soc. 2006;54(12):1905–8.

    Article  PubMed  Google Scholar 

  13. Jaafar MH, Mahadeva S, Morgan K, Tan MP. Percutaneous endoscopic gastrostomy versus nasogastric feeding in older individuals with non-stroke dysphagia: a systematic review. J Nutr Health Aging. 2015;19(2):190–7.

    Article  CAS  PubMed  Google Scholar 

  14. Wang J, Liu M, Liu C, Ye Y, Huang G. Percutaneous endoscopic gastrostomy versus nasogastric tube feeding for patients with head and neck cancer: a systematic review. J Radiat Res. 2014;55(3):559–67.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Corry J, Poon W, McPhee N, Milner AD, Cruickshank D, Porceddu SV, Rischin D, Peters LJ. Randomized study of percutaneous endoscopic gastrostomy versus nasogastric tubes for enteral feeding in head and neck cancer patients treated with (chemo)radiation. J Med Imaging Radiat Oncol. 2008;52(5):503–10.

    Article  CAS  PubMed  Google Scholar 

  16. Corry J, Poon W, McPhee N, Milner AD, Cruickshank D, Porceddu SV, Rischin D, Peters LJ. Prospective study of percutaneous endoscopic gastrostomy tubes versus nasogastric tubes for enteral feeding in patients with head and neck cancer undergoing (chemo)radiation. Head Neck. 2009;31(7):867–76.

    Article  PubMed  Google Scholar 

  17. Nugent B, Parker MJ, McIntyre IA. Nasogastric tube feeding and percutaneous endoscopic gastrostomy tube feeding in patients with head and neck cancer. J Hum Nutr Diet. 2010;23(3):277–84.

    Article  CAS  PubMed  Google Scholar 

  18. Baeten C, Hoefnagels J. Feeding via nasogastric tube or percutaneous endoscopic gastrostomy. A comparison. Scand J Gastroenterol Suppl. 1992;194:95–8.

    Article  CAS  PubMed  Google Scholar 

  19. Dorst J, Dupuis L, Petri S, Kollewe K, Abdulla S, Wolf J, Weber M, Czell D, Burkhardt C, Hanisch F, Vielhaber S, Meyer T, Frisch G, Kettemann D, Grehl T, Schrank B, Ludolph AC. Percutaneous endoscopic gastrostomy in amyotrophic lateral sclerosis: a prospective observational study. J Neurol. 2015;262(4):849–58.

    Article  PubMed  Google Scholar 

  20. Mitchell SL, Tetroe JM. Survival after percutaneous endoscopic gastrostomy placement in older persons. J Gerontol A Biol Sci Med Sci. 2000;55(12):M735–9.

    Article  CAS  PubMed  Google Scholar 

  21. Silander E, Nyman J, Bove M, Johansson L, Larsson S, Hammerlid E. Impact of prophylactic percutaneous endoscopic gastrostomy on malnutrition and quality of life in patients with head and neck cancer: a randomized study. Head Neck. 2012;34(1):1–9.

    Article  PubMed  Google Scholar 

  22. Hafner G, Neuhuber A, Hirtenfelder S, Schmedler B, Eckel HE. Fiberoptic endoscopic evaluation of swallowing in intensive care unit patients. Eur Arch Otorhinolaryngol. 2008;265(4):441–6.

    Article  PubMed  Google Scholar 

  23. Kim CH, Nelson DK. Venting percutaneous gastrostomy in the treatment of refractory idiopathic gastroparesis. Gastrointest Endosc. 1998;47(1):67–70.

    Article  CAS  PubMed  Google Scholar 

  24. Laval G, Arvieux C, Stefani L, Villard ML, Mestrallet JP, Cardin N. Protocol for the treatment of malignant inoperable bowel obstruction: a prospective study of 80 cases at Grenoble University Hospital Center. J Pain Symptom Manag. 2006;31(6):502–12.

    Article  Google Scholar 

  25. Forssell H, Noren E. A novel endoscopic weight loss therapy using gastric aspiration: results after 6 months. Endoscopy. 2015;47(1):68–71.

    PubMed  Google Scholar 

  26. Sullivan S, Stein R, Jonnalagadda S, Mullady D, Edmundowicz S. Aspiration therapy leads to weight loss in obese subjects: a pilot study. Gastroenterology. 2013;145(6):1245–52.e1-5.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Rahnemai-Azar AA, Rahnemaiazar AA, Naghshizadian R, Kurtz A, Farkas DT. Percutaneous endoscopic gastrostomy: indications, technique, complications and management. World J Gastroenterol. 2014;20(24):7739–51.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Adler DG, Baron TH, Geels W, Morgan DE, Monkemuller KE. Placement of PEG tubes through previously placed self-expanding esophageal metal stents. Gastrointest Endosc. 2001;54(2):237–41.

    Article  CAS  PubMed  Google Scholar 

  29. Ellrichmann M, Sergeev P, Bethge J, Arlt A, Topalidis T, Ambrosch P, Wiltfang J, Fritscher-Ravens A. Prospective evaluation of malignant cell seeding after percutaneous endoscopic gastrostomy in patients with oropharyngeal/esophageal cancers. Endoscopy. 2013;45(7):526–31.

    Article  CAS  PubMed  Google Scholar 

  30. Milling TJ Jr, Refaai MA, Sarode R, Lewis B, Mangione A, Durn BL, Harman A, Lee ML, Goldstein JN. Safety of a 4-factor prothrombin complex concentrate versus plasma for vitamin K antagonist reversal: an integrated analysis of two phase IIIb clinical trials. Acad Emerg Med. 2016;23(4):466–75.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Bender JS. Percutaneous endoscopic gastrostomy placement in the morbidly obese. Gastrointest Endosc. 1992;38(1):97–8.

    Article  CAS  PubMed  Google Scholar 

  32. Bochicchio GV, Guzzo JL, Scalea TM. Percutaneous endoscopic gastrostomy in the supermorbidly obese patient. JSLS. 2006;10(4):409–13.

    PubMed  PubMed Central  Google Scholar 

  33. Karhadkar AS, Naini P, Dutta SK. PEG-tube placement in a patient with extreme obesity: overcoming the technical challenges. Gastrointest Endosc. 2007;65(4):731–3.

    Article  PubMed  Google Scholar 

  34. Kynci JA, Chodash HB, Tsang TK. PEG in a patient with ascites and varices. Gastrointest Endosc. 1995;42(1):100–1.

    Article  CAS  PubMed  Google Scholar 

  35. Horiuchi A, Nakayama Y, Tanaka N. Transgastric diversion of transnasal long tube placement using a percutaneous endoscopic gastrostomy site in a patient with bowel obstruction and massive ascites due to ovarian carcinoma. Case Rep Gastroenterol. 2008;2(3):326–9.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Baltz JG, Argo CK, Al-Osaimi AM, Northup PG. Mortality after percutaneous endoscopic gastrostomy in patients with cirrhosis: a case series. Gastrointest Endosc. 2010;72(5):1072–5.

    Article  PubMed  Google Scholar 

  37. Godil A, Chen YK. Percutaneous endoscopic gastrostomy for nutrition support in pregnancy associated with hyperemesis gravidarum and anorexia nervosa. JPEN J Parenter Enteral Nutr. 1998;22(4):238–41.

    Article  CAS  PubMed  Google Scholar 

  38. Serrano P, Velloso A, Garcia-Luna PP, Pereira JL, Fernadez Z, Ductor MJ, Castro D, Tejero J, Fraile J, Romero H. Enteral nutrition by percutaneous endoscopic gastrojejunostomy in severe hyperemesis gravidarum: a report of two cases. Clin Nutr. 1998;17(3):135–9.

    Article  CAS  PubMed  Google Scholar 

  39. Senadhi V, Chaudhary J, Dutta S. Percutaneous endoscopic gastrostomy placement during pregnancy in the critical care setting. Endoscopy. 2010;42(Suppl 2):E358–9.

    Article  PubMed  Google Scholar 

  40. de Souza e MGF, Lukashok HP, Meine GC, Small IA, de Carvalho RL, Guimaraes DP, Mansur GR. Outpatient percutaneous endoscopic gastrostomy in selected head and neck cancer patients. Surg Endosc. 2009;23(7):1487–93.

    Article  Google Scholar 

  41. Dormann AJ, Wigginghaus B, Risius H, Kleimann F, Kloppenborg A, Rosemann J, Padel Y, Pohl R, Baum HH, Lubbesmeier A, Schwab J, Kuhlkamp V, Gutjahr W, Lindenburger W, Schutz H, Huchzermeyer H. Antibiotic prophylaxis in percutaneous endoscopic gastrostomy (PEG)–results from a prospective randomized multicenter trial. Z Gastroenterol. 2000;38(3):229–34.

    Article  CAS  PubMed  Google Scholar 

  42. Dormann AJ, Wigginghaus B, Risius H, Kleimann F, Kloppenborg A, Grunewald T, Huchzermeyer H. A single dose of ceftriaxone administered 30 minutes before percutaneous endoscopic gastrostomy significantly reduces local and systemic infective complications. Am J Gastroenterol. 1999;94(11):3220–4.

    Article  CAS  PubMed  Google Scholar 

  43. Gossner L, Keymling J, Hahn EG, Ell C. Antibiotic prophylaxis in percutaneous endoscopic gastrostomy (PEG): a prospective randomized clinical trial. Endoscopy. 1999;31(2):119–24.

    Article  CAS  PubMed  Google Scholar 

  44. Khashab MA, Chithadi KV, Acosta RD, Bruining DH, Chandrasekhara V, Eloubeidi MA, Fanelli RD, Faulx AL, Fonkalsrud L, Lightdale JR, Muthusamy VR, Pasha SF, Saltzman JR, Shaukat A, Wang A, Cash BD. Antibiotic prophylaxis for GI endoscopy. Gastrointest Endosc. 2015;81(1):81–9.

    Article  PubMed  Google Scholar 

  45. DeLegge MH. Percutaneous endoscopic gastrostomy. Am J Gastroenterol. 2007;102(12):2620–3.

    Article  PubMed  Google Scholar 

  46. Fukami N, Anderson MA, Khan K, Harrison ME, Appalaneni V, Ben-Menachem T, Decker GA, Fanelli RD, Fisher L, Ikenberry SO, Jain R, Jue TL, Krinsky ML, Maple JT, Sharaf RN, Dominitz JA. The role of endoscopy in gastroduodenal obstruction and gastroparesis. Gastrointest Endosc. 2011;74(1):13–21.

    Article  PubMed  Google Scholar 

  47. Campoli P, Cardoso D, Turchi M, Mota O. Clinical trial: a randomized study comparing the durability of silicone and latex percutaneous endoscopic gastrostomy tubes. Dig Endosc. 2011;23(2):135–9.

    Article  PubMed  Google Scholar 

  48. DeLegge RL, DeLegge MH. Percutaneous endoscopic gastrostomy evaluation of device materials: are we “failsafe”? Nutr Clin Pract. 2005;20(6):613–7.

    Article  PubMed  Google Scholar 

  49. Blacka J, Donoghue J, Sutherland M, Martincich I, Mitten-Lewis S, Morris P, Meredith G. Dwell time and functional failure in percutaneous endoscopic gastrostomy tubes: a prospective randomized-controlled comparison between silicon polymer and polyurethane percutaneous endoscopic gastrostomy tubes. Aliment Pharmacol Ther. 2004;20(8):875–82.

    Article  CAS  PubMed  Google Scholar 

  50. Nishiwaki S, Araki H, Hayashi M, Takada J, Iwashita M, Tagami A, Hatakeyama H, Hayashi T, Maeda T, Saito K. Inhibitory effects of carbon dioxide insufflation on pneumoperitoneum and bowel distension after percutaneous endoscopic gastrostomy. World J Gastroenterol. 2012;18(27):3565–70.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Suzuki Y, Urashima M, Ishibashi Y, Abo M, Mashiko H, Eda Y, Kusakabe T, Kawasaki N, Yanaga K. Covering the percutaneous endoscopic gastrostomy (PEG) tube prevents peristomal infection. World J Surg. 2006;30(8):1450–8.

    Article  PubMed  Google Scholar 

  52. Russell TR, Brotman M, Norris F. Percutaneous gastrostomy. A new simplified and cost-effective technique. Am J Surg. 1984;148(1):132–7.

    Article  CAS  PubMed  Google Scholar 

  53. Boswell WC, Boyd CR, Lord SA. Percutaneous endoscopic gastrostomy with T-bar fixation in children. Surg Laparosc Endosc. 1996;6(4):262–5.

    Article  CAS  PubMed  Google Scholar 

  54. Tucker AT, Gourin CG, Ghegan MD, Porubsky ES, Martindale RG, Terris DJ. ‘Push’ versus ‘pull’ percutaneous endoscopic gastrostomy tube placement in patients with advanced head and neck cancer. Laryngoscope. 2003;113(11):1898–902.

    Article  PubMed  Google Scholar 

  55. McClave SA, Chang WK. Complications of enteral access. Gastrointest Endosc. 2003;58(5):739–51.

    Article  PubMed  Google Scholar 

  56. Arora G, Rockey D, Gupta S. High in-hospital mortality after percutaneous endoscopic gastrostomy: results of a nationwide population-based study. Clin Gastroenterol Hepatol. 2013;11(11):1437–44. e3

    Article  PubMed  Google Scholar 

  57. Grant MD, Rudberg MA, Brody JA. Gastrostomy placement and mortality among hospitalized Medicare beneficiaries. JAMA. 1998;279(24):1973–6.

    Article  CAS  PubMed  Google Scholar 

  58. Blomberg J, Lagergren J, Martin L, Mattsson F, Lagergren P. Complications after percutaneous endoscopic gastrostomy in a prospective study. Scand J Gastroenterol. 2012;47(6):737–42.

    Article  PubMed  Google Scholar 

  59. Ramczykowski T, Gruning S, Gurr A, Muhr G, Horch C, Meindl R, Swol J. Aspiration pneumonia after spinal cord injury. Placement of PEG tubes as effective prevention. Unfallchirurg. 2012;115(5):427–32.

    Google Scholar 

  60. James A, Kapur K, Hawthorne AB. Long-term outcome of percutaneous endoscopic gastrostomy feeding in patients with dysphagic stroke. Age Ageing. 1998;27(6):671–6.

    Article  CAS  PubMed  Google Scholar 

  61. Horiuchi A, Nakayama Y, Sakai R, Suzuki M, Kajiyama M, Tanaka N. Elemental diets may reduce the risk of aspiration pneumonia in bedridden gastrostomy-fed patients. Am J Gastroenterol. 2013;108(5):804–10.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  62. Shang E, Geiger N, Sturm JW, Post S. Pump-assisted enteral nutrition can prevent aspiration in bedridden percutaneous endoscopic gastrostomy patients. JPEN J Parenter Enteral Nutr. 2004;28(3):180–3.

    Article  PubMed  Google Scholar 

  63. Ubogu EE, Zaidat OO. Rectus sheath hematoma complicating percutaneous endoscopic gastrostomy. Surg Laparosc Endosc Percutan Tech. 2002;12(6):430–2.

    Article  PubMed  Google Scholar 

  64. Singh D, Laya AS, Vaidya OU, Ahmed SA, Bonham AJ, Clarkston WK. Risk of bleeding after percutaneous endoscopic gastrostomy (PEG). Dig Dis Sci. 2012;57(4):973–80.

    Article  PubMed  Google Scholar 

  65. Ermis F, Ozel M, Oncu K, Yazgan Y, Demirturk L, Gurbuz AK, Akyol T, Nazik H. Indications, complications and long-term follow-up of patients undergoing percutaneous endoscopic gastrostomy: a retrospective study. Wien Klin Wochenschr. 2012;124(5–6):148–53.

    Article  PubMed  Google Scholar 

  66. Acosta RD, Abraham NS, Chandrasekhara V, Chathadi KV, Early DS, Eloubeidi MA, Evans JA, Faulx AL, Fisher DA, Fonkalsrud L, Hwang JH, Khashab MA, Lightdale JR, Muthusamy VR, Pasha SF, Saltzman JR, Shaukat A, Shergill AK, Wang A, Cash BD, DeWitt JM. The management of antithrombotic agents for patients undergoing GI endoscopy. Gastrointest Endosc. 2016;83(1):3–16.

    Article  PubMed  Google Scholar 

  67. Richter JA, Patrie JT, Richter RP, Henry ZH, Pop GH, Regan KA, Peura DA, Sawyer RG, Northup PG, Wang AY. Bleeding after percutaneous endoscopic gastrostomy is linked to serotonin reuptake inhibitors, not aspirin or clopidogrel. Gastrointest Endosc. 2011;74(1):22–34.e1.

    Article  PubMed  Google Scholar 

  68. Lee C, Im JP, Kim JW, Kim SE, Ryu DY, Cha JM, Kim EY, Kim ER, Chang DK. Risk factors for complications and mortality of percutaneous endoscopic gastrostomy: a multicenter, retrospective study. Surg Endosc. 2013;27(10):3806–15.

    Article  PubMed  Google Scholar 

  69. Fatade F, Axelrod D, Lien K, Kaplan D, Nagula S. Percutaneous endoscopic gastrostomy tube placement complicated by a gastric pseudoaneurysm and recurrent hemorrhage. Endoscopy. 2012;44(Suppl 2 UCTN):E38–9.

    PubMed  Google Scholar 

  70. Ahmad J, Thomson S, McFall B, Scoffield J, Taylor M. Colonic injury following percutaneous endoscopic-guided gastrostomy insertion. BMJ Case Rep. 2010;2010 pii: bcr0520102976.

    Google Scholar 

  71. Wiggins TF, Kaplan R, DeLegge MH. Acute hemorrhage following transhepatic PEG tube placement. Dig Dis Sci. 2007;52(1):167–9.

    Article  PubMed  Google Scholar 

  72. Siegel TR, Douglass M. Perforation of an ileostomy by a retained percutaneous endoscopic gastrostomy (PEG) tube bumper. Surg Endosc. 2004;18(2):348.

    Article  CAS  PubMed  Google Scholar 

  73. Friedmann R, Feldman H, Sonnenblick M. Misplacement of percutaneously inserted gastrostomy tube into the colon: report of 6 cases and review of the literature. JPEN J Parenter Enteral Nutr. 2007;31(6):469–76.

    Article  PubMed  Google Scholar 

  74. Rafiq A, Abbas N, Tariq H, Nayudu SK. Gastro-hepatic fistula with liver abscess: a rare complication of a common procedure. Am J Case Rep. 2015;16:652–7.

    Article  PubMed  PubMed Central  Google Scholar 

  75. Lau G, Lai SH. Fatal retroperitoneal haemorrhage: an unusual complication of percutaneous endoscopic gastrostomy. Forensic Sci Int. 2001;116(1):69–75.

    Article  CAS  PubMed  Google Scholar 

  76. Moriwaki Y, Arata S, Tahara Y, Toyoda H, Kosuge T, Suzuki N. Duodenal perforation due to compression necrosis by the tip of percutaneous endoscopic gastrostomy tube. Nutrition. 2011;27(9):979–81.

    Article  PubMed  Google Scholar 

  77. Cyrany J, Rejchrt S, Kopacova M, Bures J. Buried bumper syndrome: a complication of percutaneous endoscopic gastrostomy. World J Gastroenterol. 2016;22(2):618–27.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  78. Itkin M, MH DL, Fang JC, SA MC, Kundu S, d’Othee BJ, Martinez-Salazar GM, Sacks D, Swan TL, Towbin RB, Walker TG, Wojak JC, Zuckerman DA, Cardella JF. Multidisciplinary practical guidelines for gastrointestinal access for enteral nutrition and decompression from the society of interventional radiology and American Gastroenterological Association (AGA) Institute, with endorsement by Canadian Interventional Radiological Association (CIRA) and Cardiovascular and Interventional Radiological Society of Europe (CIRSE). Gastroenterology. 2011;141(2):742–65.

    Article  PubMed  Google Scholar 

  79. Radhakrishnan N, Sharma RK, Ellul P, George R. The “Quill” technique–another method for managing buried bumper syndrome. Gastrointest Endosc. 2006;64(4):668.

    Article  PubMed  Google Scholar 

  80. Furlano RI, Sidler M, Haack H. The push-pull T technique: an easy and safe procedure in children with the buried bumper syndrome. Nutr Clin Pract. 2008;23(6):655–7.

    Article  PubMed  Google Scholar 

  81. Anagnostopoulos GK, Kostopoulos P, Arvanitidis DM. Buried bumper syndrome with a fatal outcome, presenting early as gastrointestinal bleeding after percutaneous endoscopic gastrostomy placement. J Postgrad Med. 2003;49(4):325–7.

    CAS  PubMed  Google Scholar 

  82. Shigoka H, Maetani I, Tominaga K, Gon K, Saitou M, Takenaka Y. Comparison of modified introducer method with pull method for percutaneous endoscopic gastrostomy: prospective randomized study. Dig Endosc. 2012;24(6):426–31.

    Article  PubMed  Google Scholar 

  83. Martins FP, Sousa MC, Ferrari AP. New “introducer” PEG-gastropexy with T fasteners: a pilot study. Arq Gastroenterol. 2011;48(4):231–5.

    Article  PubMed  Google Scholar 

  84. Lipp A, Lusardi G. Systemic antimicrobial prophylaxis for percutaneous endoscopic gastrostomy. Cochrane Database Syst Rev. 2013;11:CD005571.

    Google Scholar 

  85. Lipp A, Lusardi G. Systemic antimicrobial prophylaxis for percutaneous endoscopic gastrostomy. Cochrane Database Syst Rev. 2006;4:CD005571.

    Google Scholar 

  86. Blumenstein I, Borger D, Loitsch S, Bott C, Tessmer A, Hartmann F, Stein J. A glycerin hydrogel-based wound dressing prevents peristomal infections after percutaneous endoscopic gastrostomy (PEG): a prospective, randomized study. Nutr Clin Pract. 2012;27(3):422–5.

    Article  PubMed  Google Scholar 

  87. Gottfried EB, Plumser AB, Clair MR. Pneumoperitoneum following percutaneous endoscopic gastrostomy. A prospective study. Gastrointest Endosc. 1986;32(6):397–9.

    Article  CAS  PubMed  Google Scholar 

  88. Park WY, Lee TH, Lee JS, Hong SJ, Jeon SR, Kim HG, Cho JY, Kim JO, Cho JH, Lee SW, Cho YK. Reappraisal of pneumoperitoneum after percutaneous endoscopic gastrostomy. Intest Res. 2015;13(4):313–7.

    Article  PubMed  PubMed Central  Google Scholar 

  89. Nazarian A, Cross W, Kowdley GC. Pneumoperitoneum after percutaneous endoscopic gastrostomy among adults in the intensive care unit: incidence, predictive factors, and clinical significance. Am Surg. 2012;78(5):591–4.

    PubMed  Google Scholar 

  90. Rosenberger LH, Newhook T, Schirmer B, Sawyer RG. Late accidental dislodgement of a percutaneous endoscopic gastrostomy tube: an underestimated burden on patients and the health care system. Surg Endosc. 2011;25(10):3307–11.

    Article  PubMed  PubMed Central  Google Scholar 

  91. Tsang TK, Eaton D, Falconio MA. Percutaneous ostomy dilation: a technique for dilating the closed percutaneous endoscopic gastrostomy sites and reinserting gastrostomies. Gastrointest Endosc. 1989;35(4):336–7.

    Article  CAS  PubMed  Google Scholar 

  92. Schrag SP, Sharma R, Jaik NP, Seamon MJ, Lukaszczyk JJ, Martin ND, Hoey BA, Stawicki SP. Complications related to percutaneous endoscopic gastrostomy (PEG) tubes. A comprehensive clinical review. J Gastrointestin Liver Dis. 2007;16(4):407–18.

    PubMed  Google Scholar 

  93. Singh A, Gelrud A. Adverse events associated with percutaneous enteral access. Gastrointest Endosc Clin N Am. 2015;25(1):71–82.

    Article  PubMed  Google Scholar 

  94. Scott F, Beech R, Smedley F, Timmis L, Stokes E, Jones P, Roffe C, Bowling TE. Prospective, randomized, controlled, single-blind trial of the costs and consequences of systematic nutrition team follow-up over 12 mo after percutaneous endoscopic gastrostomy. Nutrition. 2005;21(11–12):1071–7.

    Article  PubMed  Google Scholar 

  95. Heiser M, Malaty H. Balloon-type versus non-balloon-type replacement percutaneous endoscopic gastrostomy: which is better? Gastroenterol Nurs. 2001;24(2):58–63.

    Article  CAS  PubMed  Google Scholar 

  96. Nishiwaki S, Araki H, Fang JC, Hayashi M, Takada J, Iwashita M, Tagami A, Hatakeyama H, Hayashi T, Maeda T, Saito K. Retrospective analyses of complications associated with transcutaneous replacement of percutaneous gastrostomy and jejunostomy feeding devices. Gastrointest Endosc. 2011;74(4):784–91.

    Article  PubMed  Google Scholar 

  97. Westaby D, Young A, O’Toole P, Smith G, Sanders DS. The provision of a percutaneously placed enteral tube feeding service. Gut. 2010;59(12):1592–605.

    Article  PubMed  Google Scholar 

  98. Mathus-Vliegen EM, Koning H, Taminiau JA, Moorman-Voestermans CG. Percutaneous endoscopic gastrostomy and gastrojejunostomy in psychomotor retarded subjects: a follow-up covering 106 patient years. J Pediatr Gastroenterol Nutr. 2001;33(4):488–94.

    Article  CAS  PubMed  Google Scholar 

  99. Fonseca J, Santos CA. Percutaneous endoscopic gastrostomy with jejunal extension plus percutaneous endoscopic gastrostomy (PEG-j plus PEG) in patients with gastric/duodenal cancer outlet obstruction. Arq Gastroenterol. 2015;52(1):72–5.

    Article  PubMed  Google Scholar 

  100. Li Y, Wang Z, Ni X, Jiang Z, Ding K, Li N, Li J. Double percutaneous endoscopic gastrojejunostomy tubes for decompression and refeeding together with enteral nutrients: three case reports and a review of the literature. Surg Laparosc Endosc Percutan Tech. 2009;19(5):e167–70.

    Article  PubMed  Google Scholar 

  101. Lawinski M, Gradowski L, Bzikowska A, Goszczynska A, Jachnis A, Forysinski K. Gastrojejunostomy inserted through PEG (PEG-J) in prevention of aspiration pneumonia. Clinical nutrition complication in dysphagic patients. Pol Przegl Chir. 2014;86(5):223–9.

    PubMed  Google Scholar 

  102. Poteet SJ, Holzman MD, Melvin WV, Sharp KW, Poulose BK. Inpatient mortality and length of stay comparison of percutaneous endoscopic gastrostomy and percutaneous endoscopic gastrojejunostomy. J Laparoendosc Adv Surg Tech A. 2010;20(7):587–90.

    Article  PubMed  Google Scholar 

  103. Adams GF, Guest DP, Ciraulo DL, Lewis PL, Hill RC, Barker DE. Maximizing tolerance of enteral nutrition in severely injured trauma patients: a comparison of enteral feedings by means of percutaneous endoscopic gastrostomy versus percutaneous endoscopic gastrojejunostomy. J Trauma. 2000;48(3):459–64. discussion 64–5

    Article  CAS  PubMed  Google Scholar 

  104. Irving PM, Howell RJ, Shidrawi RG. Percutaneous endoscopic gastrostomy with a jejunal port for severe hyperemesis gravidarum. Eur J Gastroenterol Hepatol. 2004;16(9):937–9.

    Article  PubMed  Google Scholar 

  105. Ao P, Sebastianski M, Selvarajah V, Gramlich L. Comparison of complication rates, types, and average tube patency between jejunostomy tubes and percutaneous gastrostomy tubes in a regional home enteral nutrition support program. Nutr Clin Pract. 2015;30(3):393–7.

    Article  PubMed  Google Scholar 

  106. Kim KJ, Victor D, Stein E, Valeshabad AK, Saxena P, Singh VK, Lennon AM, Clarke JO, Khashab MA. A novel ballooned-tip percutaneous endoscopic gastrojejunostomy tube: a pilot study. Gastrointest Endosc. 2013;78(1):154–7.

    Article  PubMed  Google Scholar 

  107. Kalkan IH, Disibeyaz S, Onder FO, Oztas E, Odemis B, Ozogul Y, Parlak E. A rare complication of percutaneous endoscopic gastrojejunostomy (PEG-J): duodenal bulb perforation due to retrograde migration. Acta Gastroenterol Belg. 2012;75(2):276–7.

    PubMed  Google Scholar 

  108. Maple JT, Petersen BT, Baron TH, Gostout CJ, Wong Kee Song LM, Buttar NS. Direct percutaneous endoscopic jejunostomy: outcomes in 307 consecutive attempts. Am J Gastroenterol. 2005;100(12):2681–8.

    Article  PubMed  Google Scholar 

  109. Kav T. Direct percutaneous endoscopic jejunostomy in patients with altered anatomy. Arch Iran Med. 2012;15(3):176.

    PubMed  Google Scholar 

  110. Del Piano M, Ballare M, Carmagnola S, Orsello M, Garello E, Pagliarulo M, Sartori M, Montino F. DPEJ placement in cases of PEG insertion failure. Dig Liver Dis. 2008;40(2):140–3.

    Article  PubMed  Google Scholar 

  111. Mackenzie SH, Haslem D, Hilden K, Thomas KL, Fang JC. Success rate of direct percutaneous endoscopic jejunostomy in patients who are obese. Gastrointest Endosc. 2008;67(2):265–9.

    Article  PubMed  Google Scholar 

  112. Lim AH, Schoeman MN, Nguyen NQ. Long-term outcomes of direct percutaneous endoscopic jejunostomy: a 10-year cohort. Endosc Int Open. 2015;3(6):E610–4.

    Article  PubMed  PubMed Central  Google Scholar 

  113. Aktas H, Mensink PB, Kuipers EJ, van Buuren H. Single-balloon enteroscopy-assisted direct percutaneous endoscopic jejunostomy. Endoscopy. 2012;44(2):210–2.

    Article  CAS  PubMed  Google Scholar 

  114. Song LM, Baron TH, Saleem A, Bruining DH, Alexander JA, Rajan E. Double-balloon enteroscopy as a rescue technique for failed direct percutaneous endoscopic jejunostomy when using conventional push enteroscopy (with video). Gastrointest Endosc. 2012;76(3):675–9.

    Article  PubMed  Google Scholar 

  115. Monkemuller K, Vormbrock K, Kassalik M, Sancar A. Direct percutaneous endoscopic jejunostomy tube placement using double-balloon enteroscopy. Gastrointest Endosc. 2012;75(2):463–5.

    Article  PubMed  Google Scholar 

  116. Despott EJ, Gabe S, Tripoli E, Konieczko K, Fraser C. Enteral access by double-balloon enteroscopy: an alternative method of direct percutaneous endoscopic jejunostomy placement. Dig Dis Sci. 2011;56(2):494–8.

    Article  CAS  PubMed  Google Scholar 

  117. Alberca-de-Las-Parras F, Navalon-Rubio M, Egea-Valenzuela J, Alvarez-Higueras FJ, Anton-Rodenas G, Alajarin-Cervera M, Serrano-Gimenez A, Gil-Ortega D, Munoz-Tornero M, Ono-Ono A, Carballo-Alvarez LF. Direct percutaneous endoscopic jejunostomy in pediatric age with a pexies triangulation system: report of a case and literature review. Rev Esp Enferm Dig. 2015;107(4):240–2.

    PubMed  Google Scholar 

  118. Auvin S, Michaud L, Guimber D, Sfeir R, Gottrand F, Turck D. Percutaneous endoscopic jejunostomy for decompression in an infant with short-bowel syndrome. Endoscopy. 2002;34(3):240.

    Article  CAS  PubMed  Google Scholar 

  119. Virnig DJ, Frech EJ, Delegge MH, Fang JC. Direct percutaneous endoscopic jejunostomy: a case series in pediatric patients. Gastrointest Endosc. 2008;67(6):984–7.

    Article  PubMed  Google Scholar 

  120. Zhu Y, Shi L, Tang H, Tao G. Current considerations of direct percutaneous endoscopic jejunostomy. Can J Gastroenterol. 2012;26(2):92–6.

    Article  PubMed  PubMed Central  Google Scholar 

  121. Ishii M, Teramoto S, Yakabe M, Yamamato H, Yamaguchi Y, Hanaoka Y, Ouchi Y. Small intestinal intussusceptions caused by percutaneous endoscopic jejunostomy tube placement. J Am Geriatr Soc. 2007;55(12):2093–4.

    Article  PubMed  Google Scholar 

  122. Satoh T, Sawada K, Satoh M, Yohko K, Yamada M, Zaitsu M, Osada T, Sawaya R, Nata T, Ueno N, Moriichi K, Ikuta K, Mizukami Y, Watari J, Fujiya M, Kohgo Y. Small intestinal intussusceptions due to the placement of a percutaneous endoscopic jejunostomy tube. BMJ Case Rep. 2011;2011 pii: bcr0720103169.

    Google Scholar 

  123. Nishiwaki S, Iwashita M, Goto N, Hayashi M, Takada J, Asano T, Tagami A, Hatakeyama H, Hayashi T, Maeda T, Saito K. Predominant copper deficiency during prolonged enteral nutrition through a jejunostomy tube compared to that through a gastrostomy tube. Clin Nutr. 2011;30(5):585–9.

    Article  CAS  PubMed  Google Scholar 

  124. Rondanelli M, Peroni G, Miccono A, Guerriero F, Guido D, Perna S. Nutritional management in an elderly man with esophageal and gastric necrosis after caustic soda ingestion: a case report. Ther Clin Risk Manag. 2016;12:129–33.

    PubMed  PubMed Central  Google Scholar 

  125. Khadraoui H, Feigin KN, Fox JJ, Ong L, Shike M, Yahalom J, Noy A. Successful management of gastric perforation in stage IV diffuse large B-cell lymphoma with chemoradiation therapy, percutaneous endoscopy gastrostomy for gastric drainage, and percutaneous endoscopy jejunostomy for nutrition. Clin Lymphoma Myeloma Leuk. 2013;13(3):327–30.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. University of Texas Medical Branch, Department of Internal Medicine, Division of Gastroenterology & Hepatology, Galveston, TX, USA

    Yezaz A. Ghouri & Gurinder Luthra

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  1. Yezaz A. Ghouri
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  2. Gurinder Luthra
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Correspondence to Gurinder Luthra .

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  1. Advanced Endoscopy, Digestive Health Center, Section of Gastroenterology & Hepatology, Medical College of Georgia, Augusta University, Augusta, Georgia, USA

    Subbaramiah Sridhar

  2. Division of Gastroenterology-Hepatology, University of Connecticut Health Center, Farmington, Connecticut, USA

    George Y. Wu

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Ghouri, Y.A., Luthra, G. (2018). Percutaneous Endoscopic Gastrostomy and Jejunostomy for Feeding. In: Sridhar, S., Wu, G. (eds) Diagnostic and Therapeutic Procedures in Gastroenterology. Clinical Gastroenterology. Humana Press, Cham. https://doi.org/10.1007/978-3-319-62993-3_17

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