Evaluation of a single center on the efficacy of percutaneous endoscopic gastro-jejunostomy (PEG/J) in the therapy of Parkinson's disease with levodopa-carbidopa intestinal gel, from the experimental phase to today

Abstract

BACKGROUND: The aim of this study was to evaluate the results obtained in terms of efficacy, safety, and complication rates, in the treatment of patients with Parkinson’s disease, after the creation of a percutaneous endoscopic gastro-jejunostomy (PEG-J), with levodopa/carbidopa intestinal gel.METHODS: We report the experience of our center, from the experimental phase performed from 2009 to 2011 until today, using the “pull-string Ponsky-Gauderer type gastrostomy” technique.RESULTS: Since the experimental phase we have observed immediate relief of symptoms in all patients. We had no intraoperative complications, while at a distance, in the experimental phase, we had a case of pressure injuries at the gastric level and a case of severe inflammation of the stoma. In the following years we detected four cases of ostomy inflammation and only one case of bumper incarceration syndrome.CONCLUSIONS: Regarding the technique, PEG/J proved to be safe both in the short and long term, with a very low complication rate: the effectiveness of levodopa gel therapy, in our opinion, is important, both for the rapidity of the response to symptoms and on patient compliance.