Endoscopically Guided Laparoscopic Gastrojejunostomy Tube Placement for Patients with Distal Esophageal StentsReport as inadecuate




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Journal of Gastrointestinal Surgery

, Volume 21, Issue 8, pp 1350–1353

First Online: 08 February 2017Received: 01 December 2016Accepted: 25 January 2017

Abstract

Patients with distal esophageal pathology such as perforation, trachea-esophageal fistulae, and- or obstructing gastroesophageal junction tumor present a challenging situation in terms of feeding access where an esophageal stent is placed across the gastroesophageal junction. In order to allow simultaneous gastric decompression and post-pyloric feeds without significant reflux up through the stent, a gastrojejunostomy GJ tube is a viable option. We hereby describe a hybrid approach to placing these GJ tubes in this cohort of patients using simultaneous laparoscopy, endoscopy, and fluoroscopy with minimal manipulation of the stent itself. We have employed this technique of placing GJ tubes 2–3 days following placement of the esophageal stent in six consecutive patients. All patients tolerated the procedure well without any complications. Endoscopically guided laparoscopic GJ tubes are ideal for bridging patients, with distal esophageal pathology requiring esophageal stents, to oral intake.

KeywordsEsophageal perforation Esophageal stents Feeding access gastrojejunostomy tube placement Electronic supplementary materialThe online version of this article doi:10.1007-s11605-017-3379-0 contains supplementary material, which is available to authorized users.

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Author: Marlieke E. Nussenbaum - Edward Y. Chan - Min P. Kim - Puja G. Khaitan

Source: https://link.springer.com/article/10.1007/s11605-017-3379-0







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