{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T17:01:41Z","timestamp":1785344501389,"version":"3.55.0"},"reference-count":58,"publisher":"Georg Thieme Verlag KG","issue":"04","license":[{"start":{"date-parts":[[2022,4,14]],"date-time":"2022-04-14T00:00:00Z","timestamp":1649894400000},"content-version":"vor","delay-in-days":13,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background and study aims\u2002Endoscopic methods of delivering uninterrupted feeding to the jejunum include direct percutaneous endoscopic jejunostomy (DPEJ) or PEG with jejunal extension (PEG-J), validated from small individual studies. We aim to perform a meta-analysis to assess their effectiveness and safety in a variety of clinical scenarios.<\/jats:p><jats:p>\n          Methods\u2002Major databases were searched until June 2021.\u200aEfficacy outcomes included technical and clinical success, while safety outcomes included adverse events (AEs) and malfunction rates. We assessed heterogeneity using I2\n           and classic fail-safe to assess bias.<\/jats:p><jats:p>\n          Results\u200229 studies included 1874 patients (983 males and 809 females); mean age of 60\u200a\u00b1\u200a19 years. Pooled technical and clinical success rates with DPEJ were 86.6\u200a% (CI, 82.1\u201390.1, I2\n           73.1) and 96.9\u200a% (CI, 95.0\u201398.0, I2\n           12.7). The pooled incidence of malfunction, major and minor AEs with DPEJ were 11\u200a%, 5\u200a%, and 15\u200a%. Pooled technical and clinical success for PEG-J were 94.4\u200a% (CI, 85.5\u201397.9, I2\n           33) and 98.7\u200a% (CI, 95.5\u201399.6, I2\n          \u200a&lt;\u200a0.001). The pooled incidence of malfunction, major and minor AEs with DPEJ were 24\u200a%, 1\u200a%, and 25\u200a%. Device-assisted DPEJ performed better in altered gastrointestinal anatomy. First and second attempts were 87.6\u200a% and 90.2\u200a%.<\/jats:p><jats:p>\n          Conclusions\u2002DPEJ and PEG-J are safe and effective procedures placed with high fidelity with comparable outcomes. DPEJ was associated with fewer tube malfunction and failure rates; however, it is technically more complex and not standardized, while PEG-J had higher placement rates. The use of balloon enteroscopy was found to enhance DPEJ performance.<\/jats:p>","DOI":"10.1055\/a-1774-4736","type":"journal-article","created":{"date-parts":[[2022,4,14]],"date-time":"2022-04-14T22:30:20Z","timestamp":1649975420000},"page":"E488-E520","source":"Crossref","is-referenced-by-count":18,"title":["Direct percutaneous endoscopic jejunostomy (DPEJ) and percutaneous endoscopic gastrostomy with jejunal extension (PEG-J) technical success and outcomes: Systematic review and meta-analysis"],"prefix":"10.1055","volume":"10","author":[{"given":"Smit S.","family":"Deliwala","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Michigan State University at Hurley Medical Center, Flint, Michigan, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saurabh","family":"Chandan","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology, CHI Health Creighton University Medical Center, Omaha, Nebraska, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anand","family":"Kumar","sequence":"additional","affiliation":[{"name":"Gastroenterology & Hepatology, Lenox Hill Hospital, New York, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babu","family":"Mohan","sequence":"additional","affiliation":[{"name":"Gastroenterology & Hepatology, University of Utah, Salt Lake City, Utah, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anoosha","family":"Ponnapalli","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Michigan State University at Hurley Medical Center, Flint, Michigan, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murtaza S.","family":"Hussain","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Michigan State University at Hurley Medical Center, Flint, Michigan, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunil","family":"Kaushal","sequence":"additional","affiliation":[{"name":"Gastroenterology, Mclaren Health Corporation, Flint, Michigan, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Novak","sequence":"additional","affiliation":[{"name":"Division of Digestive Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saurabh","family":"Chawla","sequence":"additional","affiliation":[{"name":"Division of Digestive Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,4,14]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1093\/ajcn\/74.4.534","article-title":"Enteral compared with parenteral nutrition: a meta-analysis","volume":"74","author":"C L Braunschweig","year":"2001","journal-title":"Am J Clin Nutr"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"1407","DOI":"10.1136\/bmj.38118.593900.55","article-title":"Meta-analysis of parenteral nutrition versus enteral nutrition in patients with acute pancreatitis","volume":"328","author":"P E Marik","year":"2004","journal-title":"BMJ"},{"key":"ref3","first-page":"1554","volume-title":"Enteral feeding","author":"M Shike","year":"2005"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1007\/s00464-003-2187-7","article-title":"Laparoscopic feeding jejunostomy: a systematic review","volume":"19","author":"I J Han-Geurts","year":"2005","journal-title":"Surg Endosc"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1016\/j.gie.2016.06.014","article-title":"The PEG-Pedi-PEG technique: a novel method for percutaneous endoscopic gastrojejunostomy tube placement (with video)","volume":"84","author":"J B Samarasena","year":"2016","journal-title":"Gastrointest Endosc"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/j.tgie.2018.09.005","article-title":"Update on endoscopic enteral access","volume":"20","author":"K Yolsuriyanwong","year":"2018","journal-title":"Tech Gastrointest Endosc"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1055\/a-1331-8080","article-title":"Endoscopic management of enteral tubes in adult patients \u2013 Part 2: Peri- And post-procedural management. 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