[Enteral feeding of problem patients: replacement of surgical catheter jejunostomy by an endoscopic concept].

Percutaneous endoscopic gastrostomy (PEG), is widely used as a safe, effective method of providing enteral nutrition to patients in whom oral feeding is not possible. However, in patients with malnutrition after partial or total gastrectomy, anastomotic insufficiency after gastric resection or esophageal resection with gastric pull-up, esophageal perforation and fistulas, the stomach cannot be punctured. In these cases endoscopic percutaneous jejunostomy (EPJ) by direct punction of the small intestine is a reasonable alternative; the technique is described, and the results of a series of 103 EPJs are reported.