caa a22 4500 475781147 CHVBK 20180406123644.0 cr unu---uuuuu 170329e20000501xx s 000 0 eng 10.1007/s004640000163 doi (NATIONALLICENCE)springer-10.1007/s004640000163 Recent experience with percutaneous endoscopic gastrostomy/jejunostomy (PEG/J) for enteral nutrition [Elektronische Daten] [T. Simon, A. S. Fink] Background: Enteral feeding is the preferred means of nutritional support in patients unable to eat orally. Jejunal-placed feeding tubes are often considered optimal for this purpose. Successful administration of such tube feedings depends on the method of placement and the size of the tube. Herein we review our experience with endoscopically placed jejunal feeding tubes. Methods: Thirteen percutaneous endoscopic gastrostomy/jejunostomy (PEG/J) tubes were placed in 13 patients at the Emory University hospital by one surgeon. Indications for jejunal placement included aspiration in five patients and suspicion of increased reflux susceptibility in eight patients. Insertion of an 8.5-Fr nasobiliary tube was attempted in nine patients using the technique described by Coates and MacFadyen. A 12-Fr tube was placed in four patients using a technique that took advantage of previously placed PEG tubes. Results: Initial placement was successful in all but one patient. Nine tube-related complications occurred in seven patients. These included six tube occlusions, one tube site infection, one peristomal leak, and one tube perforation that required replacement. Five of six tube occlusions (83%) occurred in the smaller 8.5-Fr. tubes. There was one non-tube-related death. Conclusions: PEG/J insertion can be performed successfully and safely in most patients. Long-term tube patency is, however, dependent on the use of tubes with a large diameter; thus, modalities that enable placement of larger-sized tubes are preferable. Further technical developments are needed to facilitate the endoscopic insertion of larger jejunostomy tubes. Springer-Verlag New York Inc., 2000 Key words: Percutaneous endoscopic gastrostomy — Jejunostomy — Internal nutrition — Feeding tubes — Jejunostomy tubes nationallicence Simon T. Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA and Atlanta VAMC, Surgical Science (112), 1670 Clairmont Road, Decateur, GA 30033, USA, US aut Fink A. S. Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA and Atlanta VAMC, Surgical Science (112), 1670 Clairmont Road, Decateur, GA 30033, USA, US aut Surgical Endoscopy Springer-Verlag 14/5(2000-05-01), 436-438 0930-2794 14:5<436 2000 14 464 https://doi.org/10.1007/s004640000163 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s004640000163 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Simon T. Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA and Atlanta VAMC, Surgical Science (112), 1670 Clairmont Road, Decateur, GA 30033, USA, US aut NATIONALLICENCE 700 1- Fink A. S. Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA and Atlanta VAMC, Surgical Science (112), 1670 Clairmont Road, Decateur, GA 30033, USA, US aut NATIONALLICENCE 773 0- Surgical Endoscopy Springer-Verlag 14/5(2000-05-01), 436-438 0930-2794 14:5<436 2000 14 464 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer