Search Our Scientific Publications & Authors

Surg Case Rep 2019 Feb 20;5(1):36. Epub 2019 Feb 20.

Division of Esophageal Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.

Background: Non-occlusive mesenteric ischemia (NOMI) is a rare but life-threatening complication of early postoperative enteral feeding. We herein report two patients who developed NOMI during enteral feeding after esophagectomy.

Case Presentation: In case 1, a 75-year-old man with no medical history was diagnosed with multiple primary cancers of the esophagus, stomach, and kidney. Read More

Abdom Radiol (NY) 2019 Feb 12. Epub 2019 Feb 12.

Division of Interventional Radiology, Department of Radiology, University of California Los Angeles, 757 Westwood Plaza, Los Angeles, CA, 90095, USA.

Purpose: To report the transnasal stent-assisted targeting technique for percutaneous jejunostomy placement in patients with hiatal hernias.

Materials And Methods: Four patients, including three (75%) females and one (25%) male, with mean age of 77.5 years (range 73-78 years), and with a hiatal hernia and intrathoracic stomach precluding gastrostomy placement and loop snare placement into the mid-jejunum underwent the transnasal stent-assisted targeting technique for percutaneous jejunostomy placement. Read More

Ann Ital Chir 2018 Dec 19;7. Epub 2018 Dec 19.

Boerhaave's syndrome is a rare life-threatening condition that requires urgent surgical management. There are various methods of managing it, with the main principles of limiting sepsis, draining the area and maintaining nutrition. Although the gold standard is open thoracotomy and/or laparotomy, mostly in patients with sepsis, we present a case of a 53-year-old man treated with a combination of laparoscopic suture (3D imaging system) of the oesophageal perforation site, decompressive percutaneous endoscopic gastrostomy and feeding jejunostomy. Read More

Diagn Interv Imaging 2019 Jan 13;100(1):25-29. Epub 2018 Sep 13.

University of Minnesota, Department of Radiology, 420, Delaware St SE, 55455 Minneapolis, MN, United States. Electronic address:

Purpose: The purpose of this study was to compare the trans-abdominal (TA) and trans-oral (TO) approaches for fluoroscopic-guided gastrostomy tube placement in patients with chronic ascites.

Materials And Methods: A 10-year review of clinical imaging and medical records at a single institution identified 29 patients with chronic recurrent ascites who underwent gastrostomy (GT) or gastro-jejunostomy tube (GJT) placement. In 22 patients (18 women, 4 men) aged from 22 to 76 years of age (mean age, 57. Read More

Curr Opin Pediatr 2018 10;30(5):665-670

Department of Paediatric Surgery and urology, Children's Services, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

Purpose Of Review: A practical guide to different feeding tubes available for nutritional support in children, focused on indications, placement methods and complications.

Recent Findings: Enteral nutritional support refers to the delivery of nutrition into the gastrointestinal tract distal to the oesophagus. Different feeding tubes are available for exclusive or supplemental nutritional support in children who are unable to independently sustain their own growth, nutritional and hydration status. Read More

J Wound Ostomy Continence Nurs 2018 Jul/Aug;45(4):E1

J Wound Ostomy Continence Nurs 2018 Jul/Aug;45(4):326-334

Gabriele Roveron, RN, ULSS Rovigo, Italy. Mario Antonini, RN, USL Centro Toscana, Italy. Maria Barbierato, RN, Hospital of Padova, Italy. Vita Calandrino, RN, USL Centro Toscana, Italy. Giancarlo Canese, RN, La Spezia, Italy. Lucio Fernando Chiurazzi, RN, Dorset HealthCare University NHS Foundation Trust, Dorset, UK. Gesualdo Coniglio, RN, AUSL Ferrara, Italy. Gabriele Gentini, RN, USL Nord Ovest Toscana, Italy. Mara Marchetti, RN, University of Ancona, Italy. Andrea Minucci, RN, Department of Obstetrics and Gynecology, Hospital of Grosseto, Italy. Laura Nembrini, RN, San Carlo Clinic, Paderno Dugnano, Italy. Vanessa Neri, RN, Hospital San Martino, Genova, Italy. Paola Trovato, RN, Hospital S. Anna, Cona, Ferrara, Italy. Francesco Ferrara, MD, Department of Surgery, Unit of General Surgery and Polytrauma, San Carlo Borromeo Hospital, Milan, Italy.

Enteral nutrition (EN) is the introduction of nutrients into the gastrointestinal tract through a tube placed in a natural or artificial stoma. Tubes may be passed into the stomach (gastrostomy) or the jejunum (jejunostomy) in patients who cannot obtain adequate nourishing via oral feeding. Following placement, nurses are typically responsible for management of gastrostomy or other enteral tube devices in both the acute and home care settings. Read More

Clin Nutr Res 2018 Apr 24;7(2):136-145. Epub 2018 Apr 24.

Nutritional Sciences Department, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah 67158-47141, Iran.

Intensive care units (ICUs) provides intensive treatment medicine to avoid complications such as malnutrition, infection and even death. As very little is currently known about the nutritional practices in Iranian ICUs, this study attempted to assess the various aspects of current nutrition support practices in Iranian ICUs. We conducted a cross-sectional study on 150 critically ill patients at 18 ICUs in 12 hospitals located in 2 provinces of Iran from February 2015 to March 2016. Read More

Korean J Thorac Cardiovasc Surg 2018 Feb 5;51(1):76-80. Epub 2018 Feb 5.

Department of Thoracic and Cardiovascular Surgery, Gachon University Gil Medical Center.

Early diagnosis followed by primary repair is the best treatment for spontaneous esophageal perforation. However, the appropriate management of esophageal leakage after surgical repair is still controversial. Recently, the successful adaptation of vacuum-assisted closure therapy, which is well established for the treatment of chronic surface wounds, has been demonstrated for esophageal perforation or leakage. Read More

Gastroenterol Clin North Am 2018 Mar 7;47(1):23-37. Epub 2017 Dec 7.

Department of Medicine, Medical University of South Carolina, 25 Courtenay Street, Charleston, SC 29425, USA; DeLegge Medical, 4057 Longmarsh Road, Awendaw, SC 29429, USA. Electronic address:

Enteral access is the foundation for feeding in patients unable to meet their nutrition needs orally and have a functional gastrointestinal tract. Enteral feeding requires placement of a feeding tube. Tubes can be placed through an orifice or percutaneously into the stomach or proximal small intestine at the bedside or in specialized areas of the hospital. Read More

J Dig Dis 2018 Mar;19(3):170-176

Department of Medicine, Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Objective: To describe a novel technique for the prevention of recurrent percutaneous endoscopic gastrostomy-jejunostomy (PEG-J) tube dislodgements and assess its feasibility and efficacy. This technique utilizes endoscopic suturing to secure the PEG-J tube to the gastric wall.

Methods: This was a retrospective analysis of consecutive cases of recurrent PEG-J tube dislodgements referred to a single endoscopist between June 2016 and June 2017, using an endoscopic suturing system to secure the PEG-J tube directly to the gastric wall. Read More

Clin Imaging 2018 Jul - Aug;50:104-108. Epub 2018 Jan 10.

London Health Sciences Centre, Victoria Hospital, Western University, Department of Medical Imaging, 800 Commissioners Road East, London, Ontario N6A 5W9, Canada.

Purpose: Our objective was to assess 30-day mortality and complication rates associated with percutaneous enteral feeding tube insertion using a single-puncture, dual-suture anchor gastropexy and peel-away sheath technique. We explored differences in complications based on indication and gastrostomy versus gastrojejunostomy tube.

Methods: A retrospective review was conducted of adult patients undergoing fluoroscopically guided gastrojejunostomy (GJ) and gastrostomy (G) tube insertions between July 2011 and 2014 by five interventional radiologists at a single tertiary care centre. Read More

Gastrointest Endosc 2018 07 7;88(1):21-31.e4. Epub 2017 Dec 7.

Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Faculty of Medicine, Department of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

Background And Aims: This study prospectively recruited esophageal squamous cell carcinoma patients who received esophageal stent, nasogastric tube (NGT), or jejunostomy/gastrostomy feeding to compare the changes in nutritional status and quality of life during chemoradiation therapy (CRT).

Methods: In total, 81 patients were analyzed (stent, 7; surgical ostomy, 26; NGT, 19; oral intake, 29). An NGT was inserted when, despite medication, dysphagia or pain worsened with oral feeding during CRT. Read More

Surg Endosc 2018 May 7;32(5):2496-2504. Epub 2017 Dec 7.

Section of Surgical Endoscopy, Department of General Surgery, Cleveland Clinic Foundation, 9500 Euclid Avenue, A-100, Cleveland, OH, 44195, USA.

Introduction: Enteral access through the jejunum is indicated when patients cannot tolerate oral intake or gastric feeding. While multiple approaches for feeding jejunal access exist, few studies have compared the efficacy of these techniques. The purpose of this study was to investigate the long-term durability, re-intervention rates, and nutritional outcomes following percutaneous endoscopic gastrostomy tubes with jejunal extension tubes (PEG-JET) versus laparoscopic jejunostomy tubes (j-tubes). Read More

Rev Esp Enferm Dig 2017 10;109(10):677-678

Gastroenterology, HELIOS Bördeklinik , Germany.

Direct percutaneous endoscopic jejunostomy (DPEJ) is a useful technique to access the jejunum in order to: a) provide enteral nutrition to individuals when the gastric route is absent or contraindicated; and b) to decompress the jejunum in patients with malignant small bowel obstruction. Traditionally, DPEJ is performed using a colonoscope or enteroscope, which is advanced as deep as possible into the jejunum. The insertion technique of the feeding tube is identical to the one used for a gastrostomy tube (Ponsky-Gauderer method). Read More

J Pediatr Gastroenterol Nutr 2017 08;65(2):242-264

*Unit of Pediatrics, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Messina, Italy †Department of Paediatric Gastroenterology, Hepatology and Nutrition, Ghent University Hospital, Ghent, Belgium ‡Department of Pediatric Gastroenterology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands §Department of Pediatric Gastroenterology, Faculty of Medicine, University Children's Hospital, University of Cologne, Cologne, Germany ||Department of Paediatrics, University Hospital Motol, Prague, Czech Republic ¶Department of Digestive Endoscopy and Surgery, Bambino Gesù Children's Hospital, Rome, Italy #Department of Gastroenterology, Hepatology and Nutrition, University Children's Hospital Ljubljana, Ljubljana, Slovenia **Children's Hospital Zagreb, Zagreb, Croatia ††University Children's Hospital Ljubljana, Ljubljana, Slovenia ‡‡Division of Gastroenterology, Hepatology and Nutrition, First Department of Pediatrics, University of Athens, Children's Hospital "Agia Sofia", Athens, Greece §§Pediatric Center, Clinic des Grangettes, Geneva, Switzerland ||||Department of Pediatric Gastroenterology, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom ¶¶Pediatric Gastroenterology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel ##Department of Paediatrics, Children's Hospital, University of Oxford, Oxford, United Kingdom ***Department of Pediatric Gastroenterology, Hepatology and Nutrition, CHU Lille, University Lille, Lille, France.

Objectives: Feeding difficulties are frequent in children with neurological impairments and can be associated with undernutrition, growth failure, micronutrients deficiencies, osteopenia, and nutritional comorbidities. Gastrointestinal problems including gastroesophageal reflux disease, constipation, and dysphagia are also frequent in this population and affect quality of life and nutritional status. There is currently a lack of a systematic approach to the care of these patients. Read More

Rev Esp Enferm Dig 2017 Oct;109(10):679-683

Department of Gastroenterology and Hepatology, Centro Hospitalar de Vila Nova de Gaia/Espinho.

Background: Direct percutaneous endoscopic jejunostomy (DPEJ) is a useful method to provide enteral nutrition to individuals when gastric feeding is not possible or contraindicated. The aim of this study was to analyze the efficacy and safety of DPEJ tube placement with the Gauderer-Ponsky technique by the pull method, using single-balloon enteroscopy (SBE) without fluoroscopy.

Methods: This is a retrospective analysis of patients undergoing SBE for DPEJ placement in a referral hospital between January 2010 and March 2016. Read More

J Pediatr Hematol Oncol 2017 10;39(7):e342-e348

*Department of Pediatric Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston Departments of †Surgical Oncology ‡Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX.

The purpose of our study was to evaluate surgical enteric access in pediatric cancer patients to determine factors associated with postoperative complications. We performed a single-institution retrospective review of all patients below 21 years old with a primary cancer diagnosis who underwent surgical procedures for enteral access between 2004 and 2014. Multivariate logistic regression was performed to determine independent predictors of postoperative complications. Read More

BMJ Case Rep 2017 Jun 22;2017. Epub 2017 Jun 22.

Department of Surgery, St Joseph Mercy Ann Arbor, Ann Arbor, Michigan, USA.

Strangulated gastric prolapse through a percutaneous endoscopic gastrostomy tract is a rare and potentially life-threatening complication that requires surgical intervention. We describe a case of a 74-year-old woman who was debilitated and ventilator-dependent and who presented with acute gastric prolapse with resultant ischaemic necrosis. The patient underwent an emergent exploratory laparotomy, partial gastrectomy, repair of gastrostomy defect and placement of a gastrojejunostomy feeding tube remote to the previous location. Read More

Neurogastroenterol Motil 2017 Dec 20;29(12). Epub 2017 Jun 20.

Hepatology and Gastroenterology Division, Yokohama City University School of Medicine, Yokohama, Japan.

Backgrounds: Chronic intestinal pseudo-obstruction (CIPO) is an intractable rare digestive disease manifesting persistent small bowel distension without any mechanical cause. Intestinal decompression is a key treatment, but conventional method including a trans-nasal small intestinal tube is invasive and painful. Therefore, a less invasive and tolerable new decompression method is urgently desired. Read More

Clin Endosc 2017 Jul 17;50(4):366-371. Epub 2017 Mar 17.

Department of Gastroenterology, University of Nebraska Medical Center, Omaha, NE, USA.

Background/aims: Esophageal stricture is usually managed with outpatient endoscopic dilation. However, patients with food impaction or failure to thrive undergo inpatient dilation. Esophageal perforation is the most feared complication, and its risk in inpatient setting is unknown. Read More

Acta Gastroenterol Belg 2016 Sep-Dec;79(4):511-512

J Nippon Med Sch 2016 ;83(6):228-234

Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Graduate School of Medicine.

Background: When percutaneous endoscopic gastrostomy is not feasible, a gastrostomy tube may be inserted for enteral access by a laparoscopic or open technique. The aim of this study was to compare the postoperative pain of laparoscopic versus open gastrostomy in patients with complete obstruction caused by advanced esophageal cancer.

Methods: Fifteen patients who had undergone either a reduced port access laparoscopic gastrostomy/jejunostomy (LGJ, n=7) or open gastrostomy/jejunostomy (OGJ, n=8) between July 2011 and December 2015 were retrospectively studied. Read More

Gastroenterology Res 2016 Jun 18;9(2-3):53-55. Epub 2016 Jun 18.

Department of Internal Medicine, Hiroshima Kyoritsu Hospital, 2-20-20 Nakasu Asaminami-ku, Hiroshima City, Japan. Email:

Feeding-related adverse events after percutaneous endoscopic gastrostomy (PEG) such as aspiration pneumonia can impede the use of PEG. Percutaneous endoscopic transgastric jejunostomy (PEG-J) using large-bore jejunal tubes with gastric decompression function may improve outcomes by circumventing gastric passage during enteral nutrition and improving drainage of excessive gastric secretions. This report describes a case where PEG-J was successful in maintaining enteral tube feeding in a 72-year-old man when PEG feeding was not tolerated. Read More

Perit Dial Int 2016 9-10;36(5):562-3

Department of Artificial Organs, Akane-Foundation, Tsuchiya General Hospital, Hiroshima, Japan.

Surgical enterolysis is the final option for patients with encapsulating peritoneal sclerosis (EPS). However, EPS is sometimes refractory to surgical enterolysis. This is the first report of successful use of percutaneous endoscopic gastrostomy with jejunal extension (PEG-J) in a patient with EPS that was refractory to surgical enterolysis. Read More

Eur J Pediatr Surg 2017 Feb 5;27(1):12-15. Epub 2016 Sep 5.

Department of Paediatric Surgery, St George's Hospital, London, United Kingdom.

 Pneumatosis intestinalis (PI) is a condition in which multiple gas-filled cysts form within the wall of the gastrointestinal tract in either the subserosa or submucosa. The presence of pneumoperitoneum in the presence of PI can present a therapeutic dilemma. The aim of our study was to review our experience and management of this condition. Read More

BMJ Open Gastroenterol 2016 27;3(1):e000098. Epub 2016 Jun 27.

Department of Internal Medicine , Hiroshima Kyoritsu Hospital , Hiroshima , Japan.

Background/aims: Although percutaneous endoscopic gastrostomy (PEG) is the method of choice for long-term enteral nutrition, feeding-related adverse events such as aspiration pneumonia and peristomal leakage can impede the use of PEG. Percutaneous endoscopic transgastric jejunostomy (PEG-J) using large-bore jejunal tubes may help by circumventing gastric passage during enteral nutrition and improving drainage of gastric secretions.

Methods: 20 patients (12 males and 8 females) who received PEG-J after unsuccessful PEG feeding during a 6-year period in our institution were analysed retrospectively to evaluate the efficacy of large-bore jejunal feeding tubes in maintaining enteral nutrition. Read More

Nutr Clin Pract 2017 Apr 9;32(2):212-218. Epub 2016 Jul 9.

1 Department of Medicine 1, University of Erlangen-Nuremberg, Erlangen, Germany.

Background: An effective method for long-term enteral feeding or stomach decompression is the use of a percutaneous gastrostomy (PEG) or sometimes jejunostomy (PEJ). Under certain circumstances (eg, inadequate transillumination), endoscopic placement of PEG/PEJ tubes is impossible. In these cases, computed tomography (CT)-guided PEG/PEJ may represent an alternative technique. Read More

Support Care Cancer 2016 07 2;24(7):2877-82. Epub 2016 Feb 2.

Department of Gastroenterology, National Cancer Institute, Centro di Riferimento Oncologico IRCCS, Via Franco Gallini, 2 33081, Aviano, PN, Italy.

Purpose: The purpose of this study was to evaluate patient-centered outcomes of decompressive percutaneous endoscopic gastrostomy (dPEG) in patients with malignant bowel obstruction due to advanced gynecological and gastroenteric malignancies.

Methods: This is a prospective analysis of 158 consecutive patients with small-bowel obstruction from advanced gynecological and gastroenteric cancer who underwent PEG or percutaneous endoscopic jejunostomy (PEJ) positioning for decompressive purposes from 2002 to 2012. All of them had previous abdominal surgery and were unfit for any other surgical procedures. Read More

J Pediatr Surg 2016 Mar 11;51(3):513-8. Epub 2015 Dec 11.

Paediatric Surgical Unit, Sheffield Children Hospital.

Introduction And Aims: Gastric feeding may not be possible in the neurologically impaired child with foregut dysmotility. Post-duodenal feeding can be crucial, thereby avoiding the need for parenteral nutrition. The aim of this study is to evaluate the technical success, complication and clinical outcome of our institution's technique in creating a jejunostomy using the percutaneous laparoscopic-endoscopic jejunostomy (PLEJ) technique. Read More

Neuropsychopharmacol Hung 2015 Dec;17(4):191-6

Semmelweis University Department of Neurology, Budapest, Hungary.

Parkinson's disease is the second most common neurodegenerative disorder around the world. Levodopa has remained the "gold standard" of the therapy even several decades after its introduction. Chronic levodopa treatment is associated with the development of motor complications in most patients. Read More

Eur J Clin Nutr 2016 Mar 16;70(3):409-10. Epub 2015 Dec 16.

Department of Gastroenterology, Instituto Português de Oncologia de Lisboa Dr. Francisco Gentil, EPE, Lisbon, Portugal.

Preoperative chemoradiotherapy is the standard of care for locally advanced esophageal cancer, causing persistent deterioration in the nutritional status. We performed a prospective study to evaluate the safety and efficacy of esophageal double-covered self-expandable metal stents in patients with esophageal cancer before chemoradiotherapy. The nutritional status and dysphagia were prospectively recorded. Read More

Surg Endosc 2016 Feb 20;30(2):521-525. Epub 2015 Jun 20.

Gastroenterology and Nutrition Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA.

Background: Patients with prior pancreaticobiliary or distal gastric cancer treated surgically may have local anastomotic recurrence with obstruction of the afferent and efferent jejunal limbs. This report describes the efficacy and safety of simultaneous endoscopic insertion of self-expanding metal stents into the afferent and efferent jejunal limbs in patients with gastric outlet obstruction (GOO) of post-surgical anatomy for palliation of recurrent malignancy.

Methods: Patients were identified from an endoscopic database at a specialized cancer center between September 2007 and March 2014. Read More

Korean J Gastroenterol 2015 Jun;65(6):333-5

Division of Gastroenterology, Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan , Korea.

The prevalence of hospital malnutrition is still high in patients with digestive diseases, especially for those suffering from cancer and bowel diseases which cause malabsorption. It is well known that malnutrition is associated with delayed wound healing, impaired immunity, infection, increased complication, and poor convalenscence. Recently, nutrition screening and assessment by nutrition support team has become essential for nutrition management, and gastroenterologists comprise a dominant member of the nutrition support team. Read More

Arq Gastroenterol 2015 Jan-Mar;52(1):72-5

Hospital Garcia de Orta, Serviço de Gastrenterologia, GENE - Grupo de Estudo de Nutrição Entérica, Pragal, Almada, Portugal.

Background: Stent palliation is the gold standard for gastric/duodenal cancer outlet obstruction. When stenting is impossible, feeding may be achieved through a gastrojejunostomy (PEG-J), but displacement of jejunal tube is frequent due to manipulation for feeding and drainage. Gastric outlet obstruction results on increased gastroesophageal reflux or extra-tube leakage. Read More

J R Coll Physicians Edinb 2015 Mar;45(1):49-54

TE Bowling, Queen's Medical Centre Campus, Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK. Email

Enteral tube feeding is usually a relatively straightforward method of nutritional support, and should be facilitated by a multiprofessional team. For short-term use (<4 weeks) a fine bore feeding nasogastric tube is indicated but if longer term feeding is required then a gastrostomy is appropriate, usually inserted endoscopically (a percutaneous endoscopic gastrostomy tube). The most common serious complication of a nasogastric tube is not identifying a misplaced tube within the lungs: there are clear recommendations from the National Patient Safety Agency as to how to check tube placement. Read More

Rev Esp Enferm Dig 2015 Apr;107(4):240-2

Direct percutaneous endoscopic jejunostomy (DPEJ) is an infrequent procedure as it is not always easy to obtain transillumination, being this the main reason for failure of this technique. In patients with previous surgery, this procedure is more complex and there are only 6 reported cases in pediatric population. In our case, we provide the use of an endoscopic triangulation system with "T" pexies not used before in these cases. Read More

Ann Rehabil Med 2015 Feb 28;39(1):133-7. Epub 2015 Feb 28.

Department of Rehabilitation Medicine, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea.

Persistent enterocutaneous fistula after the removal of a gastrostomy tube is an unusual complication of percutaneous endoscopic gastrostomy (PEG). The following case report describes an 81-year-old man diagnosed with stroke and dysphagia in May 2008. The patient had been using a PEG since 2008, and PEG site infection occurred in June 2013. Read More

J Surg Res 2015 May 22;195(1):10-5. Epub 2015 Jan 22.

Department of Surgery, University of Florida College of Medicine, Gainesville, Florida.

Background: Enteral feeding via gastrostomy or jejunostomy tube is often required to adequately treat patients with cancer, gastrointestinal disorders, and cerebral vascular accident. Although sufficient to provide adequate caloric intake, the present design of a gastrostomy tube is inadequate. Leakage of gastric contents onto the skin is commonplace prompting emergency department visits and skin damage that requires costly nonoperative and operative intervention. Read More

JSLS 2014 Oct-Dec;18(4)

"Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Department of Surgery, Regional Institute of Oncology Iasi, Second Department of Oncologic Surgery, Iasi, Romania.

Background And Objectives: New therapeutic protocols for patients with end-stage Parkinson disease include a carbidopa/levodopa combination using continuous, modulated enteral administration via a portable pump. The typical approach involves a percutaneous endoscopic transgastrostomy jejunostomy (PEG-J), which requires a combination of procedures designed to ensure that no organ is interposed between the abdominal wall and the gastric surface. Lack of transillumination in maximal endoscopic light settings is a major contraindication for PEG-J, and we decided to use a different approach to establish enteric access for long-term medication delivery via pump, using a minimally invasive procedure. Read More

Gastrointest Endosc Clin N Am 2015 Jan;25(1):71-82

Division of Gastroenterology, Center for Endoscopic Research and Therapeutics (CERT), University of Chicago Medical Center, 5700 Sought Maryland Ave, Chicago, IL 60637-1470, USA. Electronic address:

Placement of percutaneous endoscopic gastrostomy or jejunostomy is a safe procedure with low periprocedural mortality, but overall mortality rates are high because of underlying disease conditions. These procedures are also associated with postprocedure complications. The clinically significant adverse events related to the procedures include infection (at tube site and peritonitis), bleeding, and aspiration. Read More

Nutr Clin Pract 2015 Jun 6;30(3):393-7. Epub 2014 Nov 6.

Division of Gastroenterology, Royal Alexandra Hospital, Edmonton, Alberta, Canada.

Background: Percutaneous endoscopic gastrostomy (PEG) tubes are common enteral access devices for long-term enteral nutrition. Jejunostomy tubes (J-tubes) are able to provide postpyloric enteral access in patients who are not PEG tube candidates. There is a scarcity of literature comparing complication rates of J-tubes to PEG tubes. Read More

Surg Endosc 2015 Jul 3;29(7):1781-6. Epub 2014 Oct 3.

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA,

Background And Study Aims: An over-the-scope clip (OTSC) device was designed for closure of acute perforations, fistulas, leaks, and non-variceal gastrointestinal bleeding. Previous data show a high rate of early fistula closure using the OTSC; however, data on long-term fistula closure are scant. We report our experience using an OTSC for closure of chronic gastrointestinal fistulas. Read More

Dig Endosc 2015 Mar 7;27(3):317-22. Epub 2014 Nov 7.

Basil I. Hirschowitz Endoscopic Center of Excellence, Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, USA.

Background And Aim: 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.

Methods: 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. Read More

Curr Gastroenterol Rep 2014 Oct;16(10):409

Department of Medicine, Loyola University Chicago, Maywood, IL, USA,

Endoscopic insertion of enteral feeding tubes is a major advance in the delivery of nutrition therapy. Since the first report of percutaneous endoscopic gastrostomy (PEG) in 1980 (Gauderer et al. J Pediatr Surg. Read More

Korean J Radiol 2014 Jul-Aug;15(4):488-93. Epub 2014 Jul 9.

Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea.

Objective: The purpose of our study was to assess the feasibility of performing percutaneous radiologic gastrostomy (PRG) in patients who had undergone partial gastrectomy and to evaluate factors associated with technical success.

Materials And Methods: Nineteen patients after partial gastrectomy, who were referred for PRG between April 2006 and April 2012, were retrospectively analyzed. The remnant stomach was punctured using a 21-gauge Chiba-needle. Read More

Voen Med Zh 2014 Apr;335(4):46-9

Percutaneous endoscopic gastrostomy for provision of the long-term enteral nutrition is well established in clinical practice because unlike from traditional gastrostomy and jejunostomy allowed to avoid many complications. The technique is used for enteral tube feeding in the absence of real positive predictive recovery of consciousness and swallowing function. During presented study from 387 patients with a gastrostomy imposed by percutaneous endoscopic technique, observed only 1,8% of suppurative complications and in 1% of cases - uncontrolled removal of the tube by the patient. Read More

World J Gastroenterol 2014 Jul;20(26):8505-24

Irina Blumenstein, Department of Gastroenterology and Clinical Nutrition, Johann Wolfgang Goethe University Clinic, 60590 Frankfurt, Germany.

Gastroenteric tube feeding plays a major role in the management of patients with poor voluntary intake, chronic neurological or mechanical dysphagia or gut dysfunction, and patients who are critically ill. However, despite the benefits and widespread use of enteral tube feeding, some patients experience complications. This review aims to discuss and compare current knowledge regarding the clinical application of enteral tube feeding, together with associated complications and special aspects. Read More

Zhonghua Er Ke Za Zhi 2014 May;52(5):349-52

Email: maming73

Case Rep Gastroenterol 2014 May 14;8(2):162-8. Epub 2014 May 14.

Department of Surgery, Jichi Medical University, Shimotsuke City, Japan.

A 41-year-old woman was admitted with upper abdominal pain, vomiting and fever. Abdominal CT scan showed a colo-duodenal fistula with inflammatory thickening of the transverse colon. The patient's general health was poor because of hypoalbuminemia and coagulopathy. Read More