Gas
trojejunal feeding
tubes (GJTs) are
typically conver
ted from gas
tros
tomy feeding
tubes by in
terven
tional radiology in many pedia
tric cen
ters
to provide bo
th pos
tpyloric feeding and gas
tric decompression. Endoscopic
transgas
tric GJT placemen
t via an es
tablished gas
tric s
toma can be performed wi
thou
t seda
tion and wi
th minimal fluoroscopy bu
t is rela
tively new in pedia
trics wi
th limi
ted descrip
tion. This s
tudy analyzed
the success ra
te, adverse even
ts, and
technical issues associa
ted wi
th endoscopic GJT placemen
t via a
transgas
tric approach in pedia
tric pa
tien
ts a
t a large children’s hospi
tal.
Methods
We retrospectively reviewed endoscopic GJT placements in pediatric patients performed over a 16-month period at the Children’s Hospital of New York-Presbyterian, Columbia University Medical Center. Indication for GJT placement, patient demographic characteristics and medical history, use of sedation, fluoroscopy time, and procedural and postprocedural adverse events were assessed.
Results
A total of 47 GJT placements were performed, all successful, in a patient cohort with a mean age of 8 years. The mean fluoroscopy time was 10 seconds, and sedation was used in 30% of placements. In 8 patients who had undergone GJT placement by endoscopy and interventional radiology, the fluoroscopy time was significantly reduced by using the endoscopic method (10 seconds vs 299 seconds, P = .001).
Conclusions
Endoscopic transgastric GJT placement via an established gastrostomy with fluoroscopic confirmation can be safely performed by pediatric gastroenterologists without sedation and with minimal radiation exposure.
