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• W2094133722 abstract "percutaneous gastrojejunostomy at Victoria Hospital from 1 987 to 1989 were reviewed. The patients included 44 males and 29 females 3-91 years old (mean age, 58 years). Thirty-seven patients had neurologic disorders, primarily due to strokes or trauma. Obstruction of the pharynx or esophagus was present in 17 patients, most of whom had malignancy. The remainder had a variety of conditions causing malnutrition, including multiorgan failure (six patients), multipIe traumatic injuries (five patients), massive burns (three patients), cystic fibrosis (two patients), malignancies (two patients), and recurrent aspiration pneumonia (one patient). The patient is kept fasting for at least 8 hr before the procedure. The left lobe of the liver is marked on the skin with the use of sonography. The stomach is drained with a nasogastric tube positioned in the fundus and inflated with air by using the bulb from a barium enema kit (E-Z-Em Co., Inc., Westbury, NY). Glucagon, 0.2 mg IV, is given only if the stomach shows excessive peristalsis. Our standard technique uses a direct “downstream” approach to the pylorus. Standing on the patient’s left side, we choose the puncture site by using anterior and lateral fluoroscopy to ensure that no bowel is interposed anterior to the stomach. The entry site is usually in the mid body of the stomach to the left of the midline and below the costal margins and is chosen to avoid the left lobe of the liver and the bowel loops. Local anesthetic is administered. The necessary equipment for the technique is available in a kit (EGJ-1 00, Cook, Bloomington, IN). An 18-gauge one-part needle is inserted through the anterior wall of the stomach and pointing slightly toward the pylorus. The guidewire is inserted and coiled in the antrum or passed directly into the duodenum. A 5.5-French torque “hockey stick” catheter is inserted over the wire, and these are manipulated into the proximal jejunum. The catheter is removed, and the tract is dilated over the wire by using an 1 1-French peel-away sheath, which has a van Andel-type dilator. The dilator and sheath are 40 cm long and usually reach the third part of the duodenum. The dilator is removed, and a 10.2-French feeding catheter is placed over the wire and through the sheath. The catheter is 70 cm long and reaches the proximaljejunum. The sheath is peeled away, and the proximal Cope loop on the catheter is formed in the stomach, and the catheter is retracted until the Cope loop just reaches the anterior wall of the stomach without forcefully apposing the loop to the stomach wall. The catheter is then stitched to the skin with a catheter retention disk and covered with Hypafix (Smith & Nephew, Lachine, Quebec). Tube feedings are begun in 2 hr if the patient is stable and there are no signs of peritonitis. The nasogastric tube is usually left in overnight to decompress the stomach. The gastrojejunostomy catheter is flushed every 8 hr with 20 ml of water to help maintain patency." @default.
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• W2094133722 date "1990-07-01" @default.
• W2094133722 modified "2023-09-24" @default.
• W2094133722 title "Percutaneous gastrojejunostomy with a modified Cope loop catheter." @default.
• W2094133722 cites W1971526771 @default.
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• W2094133722 doi "https://doi.org/10.2214/ajr.155.1.2112869" @default.
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• W2094133722 hasPublicationYear "1990" @default.
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