Safety and efficacy of direct percutaneous endoscopic jejunostomy placement in patients with previous upper gastrointestinal resection: A retrospective cohort study

DPEJ placement in patients with previous upper GI surgery has very high success rate. It is associated with lower AE rates than patients receiving DPEJ without h/o previous gastric surgery or PEGJ regardless of previous gastric surgery. Patients with a history of upper GI surgery requiring enteral access may benefit from DPEJ over PEGJ placement considering its very high success rate and lower incidence of AEs. Clinical Relevancy Percutaneous jejunal feeding tubes may be required when percutaneous gastrostomy feeding is not tolerated or high risk. Percutaneous jejunal enteral access can be obtained with percutaneous endoscopic gastrojejunostomy (PEGJ) or direct percutaneous endoscopic jejunostomy (DPEJ) tubes. Previous studies have compared success rates and outcomes for PEGJ vs. DPEJ tubes but there is limited data on outcomes of DPEJ placement in patients with previous gastric resection. We compared success rates and outcomes of patients with DPEJ and PEGJ placement with and without previous gastric resection. We found that DPEJ placement is very high with or without previous gastric resection and adverse events were lower in patients undergoing DPEJ with previous gastric resection compared to all other groups of patients undergoing percutaneous endoscopic jejunal feeding tubes. DPEJ is very feasible in patients with prior gastric resection and should be the preferred mode of percutaneous jejunal access in patients with previous gastric resection. This article is protected by copyright. All rights reserved.