Department of Endoscopy, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian Province, China.
Department of Ultrasound, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian Province, China.
Eur J Clin Nutr. 2018 Apr;72(4):618-622. doi: 10.1038/s41430-018-0115-0. Epub 2018 Feb 19.
Direct percutaneous endoscopic jejunostomy (DPEJ) is a useful method for the establishment of enteral nutrition (EN) pathway. However, the identification of stomal puncture points for DPEJ is difficult. Here we present a case treated with an improved technique for DPEJ puncture-point localization, which was named DPEJ with balloon-assisted ultrasonic localization (DPEJ-BAUL). There were four steps after insertion of an endoscope into the jejunum: (1) a balloon dilatation catheter was inserted through the endoscope working channel; (2) the balloon was fully filled with water; (3) the site of puncture was selected with an ultrasonic probe percutaneously locating the water-filled balloon; and (4) a jejunostomy tube was placed by introducer technique. Rapid localization of a puncture site was possible with BAUL and the DPEJ procedure was successful. The patient's nutritional status was improved with EN and no postoperative complications were observed. DPEJ-BAUL is a feasible and effective technique to increase the technical success rate of DPEJ in patients with negative transillumination test results.
直接经皮内镜空肠造口术（DPEJ）是建立肠内营养（EN）途径的一种有效方法。然而，DPEJ 造口穿刺点的确定较为困难。我们在此介绍了一种改良的 DPEJ 穿刺点定位技术，即球囊辅助超声定位下的 DPEJ（DPEJ-BAUL）。在内镜插入空肠后，有四个步骤：（1）通过内镜工作通道插入球囊扩张导管；（2）将球囊完全注满水；（3）经皮用超声探头定位注水球囊选择穿刺部位；（4）采用引导器技术放置空肠造口管。BAUL 可快速定位穿刺部位，DPEJ 手术成功。患者的营养状况得到改善，未出现术后并发症。DPEJ-BAUL 是一种可行且有效的技术，可提高阴性透照试验结果患者的 DPEJ 技术成功率。
