AN EASIER METHOD FOR PERCUTANEOUS ENDOSCOPIC GASTROJEJUNOSTOMY TUBE PLACEMENT

Background: The current procedures for percutaneous endoscopic gastroj ejunostomy (PEG-J) tube placement require fluoroscopy and are lime con suming. We describe a new, simple method. Methods: Ten patients had a PEG-J tube placed by the new method. After placement of a percutaneous endoscopic gastrostomy (PEG) tube using standard technique, the PEG t ube was pushed up to the pylorus to make it easier to place the jejuna l tube into the duodenum without looping in the stomach. Fluoroscopy w as not used. The position of the tube was confirmed by a plain x-ray f ilm of the abdomen. Results: The mean time required for PEG placement and jejunal tube placement was 9.0 and 8.2 minutes, respectively. In a ll patients the tip of the jejunal tube was at the ligament of Treitz. In one patient the jejunal tube formed a loop in the duodenum, but th is was reduced by spontaneous forward migration. In another patient, t he tube migrated back into the stomach after 1 week. Conclusion: The m ethod described allows easier PEG-J placement without fluoroscopy.