Short- and long-term outcomes from percutaneous endoscopic gastrostomy with jejunal extension.

Abstract

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). 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. Of 102 patients undergoing PEG-J placement, the overall technical success rate was 97%. During a median follow-up period of 22months (1-46months, n=90), at least one tube malfunction occurred in 52/90 (58%; 177 episodes) after a median of 53days (3-350days), requiring a median of two tube replacements. Short-term (<30days) 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. 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.