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Balloon-assisted ultrasonic localization: a novel technique for direct percutaneous endoscopic jejunostomy

European Journal of Clinical Nutrition volume 72, pages 618–622 (2018)Cite this article

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Abstract

Direct percutaneous endoscopic jejunostomy (DPEJ) is a useful method for the establishment of enteral nutrition (EN) pathway. However, the identification of stomal puncture points for DPEJ is difficult. Here we present a case treated with an improved technique for DPEJ puncture-point localization, which was named DPEJ with balloon-assisted ultrasonic localization (DPEJ-BAUL). There were four steps after insertion of an endoscope into the jejunum: (1) a balloon dilatation catheter was inserted through the endoscope working channel; (2) the balloon was fully filled with water; (3) the site of puncture was selected with an ultrasonic probe percutaneously locating the water-filled balloon; and (4) a jejunostomy tube was placed by introducer technique. Rapid localization of a puncture site was possible with BAUL and the DPEJ procedure was successful. The patient’s nutritional status was improved with EN and no postoperative complications were observed. DPEJ-BAUL is a feasible and effective technique to increase the technical success rate of DPEJ in patients with negative transillumination test results.

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Author notes

  1. These authors contributed equally: Zhi-Yong Yang and Jing-Jing Wei.

Authors and Affiliations

  1. Department of Endoscopy, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian Province, China

    Zhi-Yong Yang, Jing-Jing Wei, Ze-Hao Zhuang, Jun Zhang & Ya-Ting Xu

  2. Department of Ultrasound, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian Province, China

    Xiao-Hua Huang

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  1. Zhi-Yong Yang
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  2. Jing-Jing Wei
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  3. Ze-Hao Zhuang
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  4. Jun Zhang
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Correspondence to Ze-Hao Zhuang.

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The authors declare that they have no conflict of interest.

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Yang, ZY., Wei, JJ., Zhuang, ZH. et al. Balloon-assisted ultrasonic localization: a novel technique for direct percutaneous endoscopic jejunostomy. Eur J Clin Nutr 72, 618–622 (2018). https://doi.org/10.1038/s41430-018-0115-0

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