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- W3027755092 abstract "Percutaneous endoscopic gastro-jejunostomy (PEG-J) tube placement is an increasingly in demand procedure, but due to technical difficulty and its time consuming nature, is often referred to surgeons and interventional radiologists. The most common procedural complications include loop formation within the stomach which causes retraction of either the guidewire or jejunal extension tubing out of the small bowel as well as displacement of the jejunal extension tubing out of the small bowel during withdrawal of the endoscope. Here we present a through the snare technique for PEG-J placement which decreases procedure length and is easier to perform than the traditional methods. A 52-year-old male presents with his first episode of alcohol induced pancreatitis complicated by symptoms of gastric outlet obstruction. A 24 Fr PEG tube was placed in the traditional fashion. The upper endoscopy revealed a luminal stenosis in the second portion of the duodenum secondary to acute inflammation from acute pancreatitis. Next, a snare was placed through the PEG tube and opened. The endoscope is advanced through the snare and a guidewire is placed into the small bowel. The endoscope is then exchanged and the wire left in place. As the endoscope is withdrawn, through the snare, the snare is closed and the wire brought out through the PEG tube. The end of the wire not within the small bowel is then pulled back in order to straighten the guidewire. The jejunal extension tube is then advanced over the guidewire. The patient tolerated the procedure well. The procedure duration was 18 minutes. The PEG portion was immediately used for decompression and the patient was discharged after his jejunal feeds were advanced to a goal rate. This novel method for PEG-J placement is technically simple and virtually eliminates looping of the guidewire. Furthermore, it obviates the need for the use of a second endoscope as well as fluoroscopy, which may not be readily available at all centers." @default.
- W3027755092 created "2020-05-29" @default.
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- W3027755092 date "2017-05-01" @default.
- W3027755092 modified "2023-09-26" @default.
- W3027755092 title "850 A Novel Through the Snare Technique for Percutaneous Endoscopic Gastro-Jejunostomy Tube Placement" @default.
- W3027755092 doi "https://doi.org/10.1016/j.gie.2017.03.166" @default.
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