Velázquez-Aviña Jacobo, Beyer Ryan, Díaz-Tobar Claudia P, Peter Shajan, Kyanam Kabir Baig Kondal R, Wilcox C Mel, Mönkemüller Klaus
Basil I. Hirschowitz Endoscopic Center of Excellence, Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, USA.
Dig Endosc. 2015 Mar;27(3):317-22. doi: 10.1111/den.12352. Epub 2014 Nov 7.
Direct percutaneous endoscopic jejunostomy (DPEJ) is a useful method to provide nutrition to patients with a variety of gastrointestinal (GI) problems. The present study describes a new method of DPEJ using balloon-assisted-enteroscopy.
This observational, retrospective, single-arm case study conducted at a tertiary care hospital during a 15-month period included 25 patients (12 females, 13 males, mean age 54 years, age range 31-79 years) with necrotizing pancreatitis, n = 7; complex upper GI surgery, n = 6; complex fistula, n = 6; impossibility to place a gastrostomy tube, n = 5; and bowel obstruction, n = 1. The new DPEJ technique focused on three key components: (i) use of balloon-assisted overtube; (ii) use of fluoroscopy; (iii) leaving the overtube in place during the entire procedure (and also for DPEJ removal).
Technical success was 96%. Mean time of the procedure was 30.5 min (range 24 to 45 min). Clinical success was 100% (24/24); all DPEJ could be used for their intended purpose.
This new method of inserting a DPEJ using balloon enteroscopy and fluoroscopy was safe and successful. Future comparative studies are now warranted.
直接经皮内镜空肠造口术（DPEJ）是为患有各种胃肠道（GI）问题的患者提供营养的一种有用方法。本研究描述了一种使用球囊辅助肠镜检查的新型DPEJ方法。
在一家三级护理医院进行的这项为期15个月的观察性、回顾性、单臂病例研究纳入了25例患者（12例女性，13例男性，平均年龄54岁，年龄范围31 - 79岁），其中坏死性胰腺炎患者7例；复杂上消化道手术患者6例；复杂瘘管患者6例；无法放置胃造口管患者5例；肠梗阻患者1例。新型DPEJ技术着重于三个关键部分：（i）使用球囊辅助外套管；（ii）使用荧光透视检查；（iii）在整个手术过程中（以及拔除DPEJ时）保留外套管在位。
技术成功率为96%。手术平均时间为30.5分钟（范围24至45分钟）。临床成功率为100%（24/24）；所有DPEJ均能达到预期目的。
这种使用球囊肠镜检查和荧光透视检查插入DPEJ的新方法安全且成功。现在有必要进行未来的比较研究。
