1. Short- and long-term outcomes from percutaneous endoscopic gastrostomy with jejunal extension.
- Author
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Ridtitid, Wiriyaporn, Lehman, Glen, Watkins, James, Mchenry, Lee, Fogel, Evan, Sherman, Stuart, Coté, Gregory, Lehman, Glen A, Watkins, James L, Fogel, Evan L, and Coté, Gregory A
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PERCUTANEOUS endoscopic gastrostomy , *JEJUNOILEAL bypass , *CHRONIC pancreatitis , *BODY mass index , *HOSPITAL care , *INPATIENT care , *PATIENTS , *PHYSIOLOGY , *JEJUNUM surgery , *PANCREATITIS , *ENTERAL feeding , *GASTROSTOMY , *LONGITUDINAL method , *HEALTH outcome assessment , *RESEARCH funding , *SURGICAL complications , *RETROSPECTIVE studies , *ACUTE diseases , *ENDOSCOPIC gastrointestinal surgery , *EQUIPMENT & supplies , *SURGERY - Abstract
Background: There is a paucity of data regarding the safety and efficacy of percutaneous endoscopic gastrostomy with jejunal extension (PEG-J). We evaluated adverse events related to PEG-J and determined the clinical impact of PEG-J in those with chronic pancreatitis (CP).Methods: This cohort study included all patients who underwent PEG-J placement in a tertiary-care academic medical center between 2010 and 2012. Main outcome measurements were (1) short- and long-term complications related to PEG-J and (2) changes in weight and hospitalizations during the 12-month period before and after PEG-J in the CP subgroup.Results: Of 102 patients undergoing PEG-J placement, the overall technical success rate was 97 %. During a median follow-up period of 22 months (1-46 months, n = 90), at least one tube malfunction occurred in 52/90 (58 %; 177 episodes) after a median of 53 days (3-350 days), requiring a median of two tube replacements. Short-term (<30 days) tube malfunction occurred in 28/90 (31 %) and delayed in 24/90 (27 %); these included dislodgement (29 %), clogging (26 %) and kinking (14 %). In the CP subgroup (n = 58), mean body weight (kg) (70 vs. 71, p = 0.06) and body mass index (kg/m2, 26 vs. 27, p = 0.05) increased post-PEG-J. Mean number of hospitalizations (5 vs. 2, p < 0.0001) and inpatient days per 12 months (22 vs. 12, p = 0.005) decreased.Conclusions: While we observed no major complications related to PEG-J, half of patients had at least one episode of tube malfunction. In the CP subgroup, jejunal feeding via PEG-J significantly reduced the number of hospitalizations and inpatients days, while improving nutritional parameters. [ABSTRACT FROM AUTHOR]- Published
- 2017
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