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Authors
Advisor(s)
Abstract(s)
"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."
Description
Keywords
Gastrostomy Jejunostomy Gastric outlet obstruction Stomach neoplasms
Citation
Percutaneous endoscopic gastrostomy with jejunal extension plus percutaneous endoscopic gastrostomy (PEG-J plus PEG) in patients with gastric/duodenal cancer outlet obstruction. Arq Gastroenterol. 2015 Jan-Mar;52(1):72-5. doi: 10.1590/S0004-28032015000100015.
Publisher
IBEPEGE, CBCD, SBMD, FBG, SBH, SOBED