PERCUTANEOUS ENDOSCOPIC GASTROSTOMY WITH JEJUNAL EXTENSION PLUS PERCUTANEOUS ENDOSCOPIC GASTROSTOMY (PEG-J PLUS PEG) IN PATIENTS WITH GASTRIC/DUODENAL CANCER OUTLET OBSTRUCTION
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 obstruc...
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| Format: | Article |
| Language: | English |
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Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia (IBEPEGE)
2015-03-01
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| Series: | Arquivos de Gastroenterologia |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032015000100015&lng=en&tlng=en |
| _version_ | 1819260188673179648 |
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| author | Jorge FONSECA Carla Adriana SANTOS |
| author_facet | Jorge FONSECA Carla Adriana SANTOS |
| author_sort | Jorge FONSECA |
| collection | DOAJ |
| description | 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. In order to reduce the jejunostomy tube manipulation and the gastric residuum, we created a second gastrostomy (PEG) dedicated to gastric drainage, reducing the PEG-J handling. Objective Our aim was evaluating of the usefulness of an added second gastrostomy in a PEG-J patient, for: 1. controlling symptomatic reflux and extra-tube leakage; 2. preventing jejunal tube dislocation. Methods We retrospectively evaluated patients were stent palliation of gastric/duodenal cancer outlet obstruction was not achieved, who were referred and underwent PEG-J. We selected four of these patients who needed a second PEG dedicated to gastric drainage, which was performed a few centimetres apart from the gastrojejunostomy. In order to achieve an efficient gastric drainage and provide the maximum comfort to the patient, the drainage PEG tube could be linked to an ileostomy bag. Results The four PEG-J cancer patients with longer survival developed symptoms associated with an important gastric residuum. After the drainage gastrostomy, symptoms subsided or vanished and there were no jejunal tube dislocations. Conclusions When stenting is not possible in patients with gastric/duodenal outlet obstruction due to cancer growing, feeding PEG-J plus drainage PEG may be an alternative, allowing duodenal/jejunal feeding and gastric drainage with minimal manipulation of the jejunal tube. |
| first_indexed | 2024-12-23T19:21:56Z |
| format | Article |
| id | doaj.art-8b0b1ac65f854d0bbc92efe9dc5c5663 |
| institution | Directory Open Access Journal |
| issn | 1678-4219 |
| language | English |
| last_indexed | 2024-12-23T19:21:56Z |
| publishDate | 2015-03-01 |
| publisher | Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia (IBEPEGE) |
| record_format | Article |
| series | Arquivos de Gastroenterologia |
| spelling | doaj.art-8b0b1ac65f854d0bbc92efe9dc5c56632022-12-21T17:34:08ZengInstituto Brasileiro de Estudos e Pesquisas de Gastroenterologia (IBEPEGE)Arquivos de Gastroenterologia1678-42192015-03-01521727510.1590/S0004-28032015000100015S0004-28032015000100015PERCUTANEOUS ENDOSCOPIC GASTROSTOMY WITH JEJUNAL EXTENSION PLUS PERCUTANEOUS ENDOSCOPIC GASTROSTOMY (PEG-J PLUS PEG) IN PATIENTS WITH GASTRIC/DUODENAL CANCER OUTLET OBSTRUCTIONJorge FONSECACarla Adriana SANTOSBackground 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. In order to reduce the jejunostomy tube manipulation and the gastric residuum, we created a second gastrostomy (PEG) dedicated to gastric drainage, reducing the PEG-J handling. Objective Our aim was evaluating of the usefulness of an added second gastrostomy in a PEG-J patient, for: 1. controlling symptomatic reflux and extra-tube leakage; 2. preventing jejunal tube dislocation. Methods We retrospectively evaluated patients were stent palliation of gastric/duodenal cancer outlet obstruction was not achieved, who were referred and underwent PEG-J. We selected four of these patients who needed a second PEG dedicated to gastric drainage, which was performed a few centimetres apart from the gastrojejunostomy. In order to achieve an efficient gastric drainage and provide the maximum comfort to the patient, the drainage PEG tube could be linked to an ileostomy bag. Results The four PEG-J cancer patients with longer survival developed symptoms associated with an important gastric residuum. After the drainage gastrostomy, symptoms subsided or vanished and there were no jejunal tube dislocations. Conclusions When stenting is not possible in patients with gastric/duodenal outlet obstruction due to cancer growing, feeding PEG-J plus drainage PEG may be an alternative, allowing duodenal/jejunal feeding and gastric drainage with minimal manipulation of the jejunal tube.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032015000100015&lng=en&tlng=enGastrostomiaJejunostomiaObstrução da saída gástricaNeoplasias gástricas |
| spellingShingle | Jorge FONSECA Carla Adriana SANTOS PERCUTANEOUS ENDOSCOPIC GASTROSTOMY WITH JEJUNAL EXTENSION PLUS PERCUTANEOUS ENDOSCOPIC GASTROSTOMY (PEG-J PLUS PEG) IN PATIENTS WITH GASTRIC/DUODENAL CANCER OUTLET OBSTRUCTION Arquivos de Gastroenterologia Gastrostomia Jejunostomia Obstrução da saída gástrica Neoplasias gástricas |
| title | PERCUTANEOUS ENDOSCOPIC GASTROSTOMY WITH JEJUNAL EXTENSION PLUS PERCUTANEOUS ENDOSCOPIC GASTROSTOMY (PEG-J PLUS PEG) IN PATIENTS WITH GASTRIC/DUODENAL CANCER OUTLET OBSTRUCTION |
| title_full | PERCUTANEOUS ENDOSCOPIC GASTROSTOMY WITH JEJUNAL EXTENSION PLUS PERCUTANEOUS ENDOSCOPIC GASTROSTOMY (PEG-J PLUS PEG) IN PATIENTS WITH GASTRIC/DUODENAL CANCER OUTLET OBSTRUCTION |
| title_fullStr | PERCUTANEOUS ENDOSCOPIC GASTROSTOMY WITH JEJUNAL EXTENSION PLUS PERCUTANEOUS ENDOSCOPIC GASTROSTOMY (PEG-J PLUS PEG) IN PATIENTS WITH GASTRIC/DUODENAL CANCER OUTLET OBSTRUCTION |
| title_full_unstemmed | PERCUTANEOUS ENDOSCOPIC GASTROSTOMY WITH JEJUNAL EXTENSION PLUS PERCUTANEOUS ENDOSCOPIC GASTROSTOMY (PEG-J PLUS PEG) IN PATIENTS WITH GASTRIC/DUODENAL CANCER OUTLET OBSTRUCTION |
| title_short | PERCUTANEOUS ENDOSCOPIC GASTROSTOMY WITH JEJUNAL EXTENSION PLUS PERCUTANEOUS ENDOSCOPIC GASTROSTOMY (PEG-J PLUS PEG) IN PATIENTS WITH GASTRIC/DUODENAL CANCER OUTLET OBSTRUCTION |
| title_sort | percutaneous endoscopic gastrostomy with jejunal extension plus percutaneous endoscopic gastrostomy peg j plus peg in patients with gastric duodenal cancer outlet obstruction |
| topic | Gastrostomia Jejunostomia Obstrução da saída gástrica Neoplasias gástricas |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032015000100015&lng=en&tlng=en |
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