Patient Characteristics and Outcomes of Endoscopically Placed Dedicated Transgastric Jejunal Tubes Compared to Percutaneous Endoscopic Gastrostomy With Jejunal Extension Tubes

Objectives

Patients requiring long-term enteral nutrition or continuous infusion of carbidopa/levodopa can benefit from jejunostomy tube placement. Recently, directly placed percutaneous transgastric jejunal tubes (TGJs) have been used instead of gastrostomy tubes with jejunal extensions (PEG-Js) for enteral access. We aim to compare patient characteristics and outcomes after placement of TGJs placed via the introducer technique compared to PEG-Js.

Methods

We performed a retrospective study of 141 patients (TGJ = 58, PEG-J = 83) assessed at Mayo Clinic between 2010 and 2024. Patients were identified using a prospectively maintained procedure data registry. Demographic data, patient characteristics, procedural indications, complications, and first-replacement date were gathered. Statistical analysis included the Wilcoxon rank sum test, chi-square test, Fisher's exact test, and Kaplan-Meier estimates. Patients receiving carbidopa/levodopa were excluded from complications analysis due to the carbidopa/levodopa tube's proprietary structure. A p-value of <0.05 was set as a threshold for significance.

Results

Our results demonstrated no difference in cumulative incidence of complications within 1 year for TGJs and PEG-Js, p-value 0.48. Regarding time to first replacement, treating death as a competing risk factor, there was no statistically significant difference in cumulative incidence of replacement within 1 year for TGJs and PEG-Js, p-value 0.389.

Conclusions

Our study demonstrates that both direct TGJs and PEG-Js are safe options for long-term jejunal feeding. More studies are needed to compare endoscopic to radiologically placed percutaneous transgastric jejunal feeding tubes.