Direct Percutaneous Endoscopic Jejunostomy Effective Alternative to surgical jejunostomy for Feeding Access
A recent retrospective study by John Locke and team suggests important inputs on the efficacy and safety of various methods for jejunostomy tube placements which provides enteral access for patients who are unable to meet nutritional needs orally. The findings were published in the journal of Gastrointestinal Endoscopy.
The study was conducted to compare procedural success rates and complications by examining three approaches: direct percutaneous endoscopic jejunostomy (DPEJ), laparoscopic (lap-J), and open laparotomy (open-J). These methods are imperative for patients who require alternative feeding routes due to their inability to consume sufficient nutrients orally.
The research was based on data from 201 patients which was classified into DPEJ, lap-J, and open-J cohorts, demonstrated comparable procedural success rates among the three groups (DPEJ 96.9%, Lap-J 99.1%, Open-J 100%, p=0.702). The infection and bleeding rates were also similar across the board with no reported cases of gastrointestinal perforation.
This study uncovered significant findings related to tube dysfunction within 90 days. The cases requiring complete removal and/or replacement were notably lower in the DPEJ group (0%) when compared to the surgical groups (lap-J 35.1%, open-J 40.0%, p<0.001). This discrepancy was primarily from increased incidents of tube clogging and dislodgement in the surgical approaches.
The findings of the study concludes that DPEJ emerges is a safe and effective alternative to surgical jejunostomy for eligible patients. DPEJ might offer a potential advantage beyond its efficacy by significantly reducing the complication rates at the critical 90-day mark. This outcomes are important for medical practitioners and patients who seek optimal enteral access solutions when considering the postoperative recovery and maintenance aspects of the jejunostomy tube placements.
Reference:
Locke, J., Norwood, D., Forrister, N., Ahmed, A. M., Aryan, M., Oster, R., Reddy, S., Kabir Baig, K. K., & Peter, S. (2023). Safety and Efficacy of Direct Percutaneous Endoscopic Jejunostomy Tube Placement Compared with Surgical Jejunostomy: A Tertiary Care Analysis. In Gastrointestinal Endoscopy. Elsevier BV. https://doi.org/10.1016/j.gie.2023.12.013
