Endoscopically placed nasogastrojejunal feeding tubes

A safe route for enteral nutrition in patients with hepatic encephalopathy

Steven S. Lee, Ronald A. Mathiasen, Craig A. Lipkin, Steven D Colquhoun, Daniel R. Margulies

Research output: Contribution to journalReview article

5 Citations (Scopus)

Abstract

Patients with hepatic encephalopathy are at particular risk for aspiration when given oral or gastric feedings. An ideal strategy might combine distal enteral feeding with proximal gastric decompression, which is offered by a nasogastrojejunal (NGJ) feeding tube. One objective was to determine the efficacy and safety of endoscopically placed NGJ feeding tubes in patients with hepatic encephalopathy. Charts of patients who underwent NGJ tube placements between April 1997 and January 2000 were retrospectively reviewed. Two endoscopic techniques ("push" and "pull") were used. Eighteen patients (nine male and nine female) underwent 32 procedures. Twelve patients had undergone liver transplantation, four had decompensated cirrhosis, and two had fulminant hepatic failure. Twenty procedures used the push technique and 12 required the pull technique. The insertion time was shorter for the push technique compared with the pull technique (21.8 vs 39.6 min, P < 0.05). Enteral feedings were begun at an average of 5.2 hours after tube placement. The tubes remained in place for an average of 13.9 days. Complications related to the NGJ tubes included self-removal in eight, tube clogging in five, proximal migration in four, and intraduodenal migration of the gastric port in one. No aspiration episodes occurred. We conclude that NGJ feeding tubes may be placed endoscopically as a bedside procedure for patients with hepatic encephalopathy and provide a safe, efficacious, and rapid route for enteral nutrition in these patients.

Original languageEnglish (US)
Pages (from-to)196-200
Number of pages5
JournalAmerican Surgeon
Volume68
Issue number2
StatePublished - Dec 1 2002
Externally publishedYes

Fingerprint

Hepatic Encephalopathy
Enteral Nutrition
Stomach
Acute Liver Failure
Decompression
Liver Transplantation
Fibrosis
Safety

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

Cite this

Endoscopically placed nasogastrojejunal feeding tubes : A safe route for enteral nutrition in patients with hepatic encephalopathy. / Lee, Steven S.; Mathiasen, Ronald A.; Lipkin, Craig A.; Colquhoun, Steven D; Margulies, Daniel R.

In: American Surgeon, Vol. 68, No. 2, 01.12.2002, p. 196-200.

Research output: Contribution to journalReview article

Lee, Steven S. ; Mathiasen, Ronald A. ; Lipkin, Craig A. ; Colquhoun, Steven D ; Margulies, Daniel R. / Endoscopically placed nasogastrojejunal feeding tubes : A safe route for enteral nutrition in patients with hepatic encephalopathy. In: American Surgeon. 2002 ; Vol. 68, No. 2. pp. 196-200.
@article{553f6d5ee83a43abb170b94e4cf3967f,
title = "Endoscopically placed nasogastrojejunal feeding tubes: A safe route for enteral nutrition in patients with hepatic encephalopathy",
abstract = "Patients with hepatic encephalopathy are at particular risk for aspiration when given oral or gastric feedings. An ideal strategy might combine distal enteral feeding with proximal gastric decompression, which is offered by a nasogastrojejunal (NGJ) feeding tube. One objective was to determine the efficacy and safety of endoscopically placed NGJ feeding tubes in patients with hepatic encephalopathy. Charts of patients who underwent NGJ tube placements between April 1997 and January 2000 were retrospectively reviewed. Two endoscopic techniques ({"}push{"} and {"}pull{"}) were used. Eighteen patients (nine male and nine female) underwent 32 procedures. Twelve patients had undergone liver transplantation, four had decompensated cirrhosis, and two had fulminant hepatic failure. Twenty procedures used the push technique and 12 required the pull technique. The insertion time was shorter for the push technique compared with the pull technique (21.8 vs 39.6 min, P < 0.05). Enteral feedings were begun at an average of 5.2 hours after tube placement. The tubes remained in place for an average of 13.9 days. Complications related to the NGJ tubes included self-removal in eight, tube clogging in five, proximal migration in four, and intraduodenal migration of the gastric port in one. No aspiration episodes occurred. We conclude that NGJ feeding tubes may be placed endoscopically as a bedside procedure for patients with hepatic encephalopathy and provide a safe, efficacious, and rapid route for enteral nutrition in these patients.",
author = "Lee, {Steven S.} and Mathiasen, {Ronald A.} and Lipkin, {Craig A.} and Colquhoun, {Steven D} and Margulies, {Daniel R.}",
year = "2002",
month = "12",
day = "1",
language = "English (US)",
volume = "68",
pages = "196--200",
journal = "American Surgeon",
issn = "0003-1348",
publisher = "Southeastern Surgical Congress",
number = "2",

}

TY - JOUR

T1 - Endoscopically placed nasogastrojejunal feeding tubes

T2 - A safe route for enteral nutrition in patients with hepatic encephalopathy

AU - Lee, Steven S.

AU - Mathiasen, Ronald A.

AU - Lipkin, Craig A.

AU - Colquhoun, Steven D

AU - Margulies, Daniel R.

PY - 2002/12/1

Y1 - 2002/12/1

N2 - Patients with hepatic encephalopathy are at particular risk for aspiration when given oral or gastric feedings. An ideal strategy might combine distal enteral feeding with proximal gastric decompression, which is offered by a nasogastrojejunal (NGJ) feeding tube. One objective was to determine the efficacy and safety of endoscopically placed NGJ feeding tubes in patients with hepatic encephalopathy. Charts of patients who underwent NGJ tube placements between April 1997 and January 2000 were retrospectively reviewed. Two endoscopic techniques ("push" and "pull") were used. Eighteen patients (nine male and nine female) underwent 32 procedures. Twelve patients had undergone liver transplantation, four had decompensated cirrhosis, and two had fulminant hepatic failure. Twenty procedures used the push technique and 12 required the pull technique. The insertion time was shorter for the push technique compared with the pull technique (21.8 vs 39.6 min, P < 0.05). Enteral feedings were begun at an average of 5.2 hours after tube placement. The tubes remained in place for an average of 13.9 days. Complications related to the NGJ tubes included self-removal in eight, tube clogging in five, proximal migration in four, and intraduodenal migration of the gastric port in one. No aspiration episodes occurred. We conclude that NGJ feeding tubes may be placed endoscopically as a bedside procedure for patients with hepatic encephalopathy and provide a safe, efficacious, and rapid route for enteral nutrition in these patients.

AB - Patients with hepatic encephalopathy are at particular risk for aspiration when given oral or gastric feedings. An ideal strategy might combine distal enteral feeding with proximal gastric decompression, which is offered by a nasogastrojejunal (NGJ) feeding tube. One objective was to determine the efficacy and safety of endoscopically placed NGJ feeding tubes in patients with hepatic encephalopathy. Charts of patients who underwent NGJ tube placements between April 1997 and January 2000 were retrospectively reviewed. Two endoscopic techniques ("push" and "pull") were used. Eighteen patients (nine male and nine female) underwent 32 procedures. Twelve patients had undergone liver transplantation, four had decompensated cirrhosis, and two had fulminant hepatic failure. Twenty procedures used the push technique and 12 required the pull technique. The insertion time was shorter for the push technique compared with the pull technique (21.8 vs 39.6 min, P < 0.05). Enteral feedings were begun at an average of 5.2 hours after tube placement. The tubes remained in place for an average of 13.9 days. Complications related to the NGJ tubes included self-removal in eight, tube clogging in five, proximal migration in four, and intraduodenal migration of the gastric port in one. No aspiration episodes occurred. We conclude that NGJ feeding tubes may be placed endoscopically as a bedside procedure for patients with hepatic encephalopathy and provide a safe, efficacious, and rapid route for enteral nutrition in these patients.

UR - http://www.scopus.com/inward/record.url?scp=0036481506&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036481506&partnerID=8YFLogxK

M3 - Review article

VL - 68

SP - 196

EP - 200

JO - American Surgeon

JF - American Surgeon

SN - 0003-1348

IS - 2

ER -