Percutaneous endoscopic jejunostomy in patients with gastroparesis following lung transplantation: feasibility and clinical outcome

E. Toussaint; A. Van Gossum; A. Ballarin; O. Le Moine; M. Estenne; C. Knoop; J. Devière; M. Arvanitakis

doi:10.1055/s-0032-1309735

Endoscopy, Inhaltsverzeichnis

Endoscopy 2012; 44(08): 772-775
DOI: 10.1055/s-0032-1309735

Case report/series

Percutaneous endoscopic jejunostomy in patients with gastroparesis following lung transplantation: feasibility and clinical outcome

E. Toussaint

¹Medicine Department, Jules Bordet Institute, Brussels, Belgium

,

A. Van Gossum

²Department of Gastroenterology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium

,

A. Ballarin

²Department of Gastroenterology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium

,

O. Le Moine

²Department of Gastroenterology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium

,

M. Estenne

³Department of Pneumology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium

,

C. Knoop

³Department of Pneumology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium

,

J. Devière

²Department of Gastroenterology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium

,

M. Arvanitakis

²Department of Gastroenterology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium

› Institutsangaben

Abstract

The aim of the present study was to describe success rates, complications, and outcome in patients who underwent percutaneous endoscopic jejunostomy (PEJ) because of gastroparesis due to previous lung transplantation. Between October 2008 and May 2011, 14 attempts at PEJ placement were made in 12 patients in our center. Of the 14 attempts, 11 were successful, giving a technical success rate of 78.6 %. Median duration of follow-up was 8.5 months (2 – 15 months). No immediate complications were reported. Two severe complications occurred during follow up (one volvulus and one jejunocolic fistula). Jejunal nutrition was well tolerated in most of patients (9 /10). PEJ insertion is a feasible technique, which could help to provide nutritional support for patients with gastroparesis and previous lung transplantation.

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Referenzen

References
1 Abell TL, Bernstein RK, Cutts T et al. Treatment of gastroparesis: a multidisciplinary clinical review. Neurogastroenterol Motil 2006; 18: 263-283
2 Parkman HP, Yates K, Hasler WL et al. Clinical features of idiopathic gastroparesis vary with sex, body mass, symptom onset, delay in gastric emptying, and gastroparesis severity. Gastroenterology 2011; 140: 101-115
3 Berkowitz N, Schulman LL, McGregor C et al. Gastroparesis after lung transplantation. Potential role in postoperative respiratory complications. Chest 1995; 108: 1602-1607
4 Paul S, Escareno CE, Clancy K et al. Gastrointestinal complications after lung transplantation. J Heart Lung Transplant 2009; 28: 475-479
5 Schwebel C, Pin I, Barnoud D et al. Prevalence and consequences of nutritional depletion in lung transplant candidates. Eur Respir J 2000; 16: 1050-1055
6 Shike M, Latkany L, Gerdes H et al. Direct percutaneous endoscopic jejunostomies for enteral feeding. Gastrointest Endosc 1996; 44: 536-540
7 Rumalla A, Baron TH. Results of direct percutaneous endoscopic jejunostomy, an alternative method for providing jejunal feeding. Mayo Clin Proc 2000; 75: 807-810
8 Maple JT, Petersen BT, Baron TH et al. Direct percutaneous endoscopic jejunostomy: outcomes in 307 consecutive attempts. Am J Gastroenterol 2005; 100: 2681-2688
9 Löser C, Aschl G, Hébuterne X et al. ESPEN guidelines on artificial enteral nutrition – Percutaneous endoscopic gastrostomy (PEG). Clinical Nutrition 2005; 24: 848-861
10 Clark CJ, Sarr MG, Arora AS. Does gastric resection have a role in the management of severe postfundoplication gastric dysfunction?. World J Surg 2011; 35: 2045-2050
11 Bai Y, Xu MJ, Yang X et al. A systematic review on intrapyloric botulinum toxin injection for gastroparesis. Digestion 2010; 81: 27-34
12 Panagiotakis PH, DiSario JA, Hilden K et al. DPEJ tube placement prevents aspiration pneumonia in high-risk patients. Nutr Clin Pract 2008; 23: 172-175
13 Tang DM, Friedenberg FK. Gastroparesis: approach, diagnostic evaluation, and management. Dis Mon 2011; 57: 74-101
14 Fan AC, Baron TH, Rumalla A et al. Comparison of direct percutaneous endoscopic jejunostomy and PEG with jejunal extension. Gastrointest Endosc 2002; 56: 890-894
15 Llaguna OH, Kim HJ, Deal AM et al. Utilization and morbidity associated with placement of a feeding jejunostomy at the time of gastroesophageal resection. J Gastrointest Surg 2011; 15: 1663-1669