{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T04:09:09Z","timestamp":1767845349126,"version":"3.49.0"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec>\n            <jats:title>Purpose of review<\/jats:title>\n            <jats:p>The current review summarizes current evidence regarding the indications, contraindications, and technical aspects of placing a direct percutaneous endoscopic jejunostomy (DPEJ), as well as procedure-related and patient-related outcomes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Recent findings<\/jats:title>\n            <jats:p>DPEJ is indicated for patients who require long-term (&gt;4\u200aweeks) jejunal nutrition due to existing altered foregut anatomy (e.g., previous gastrectomy) or because the gastric route is not an option (e.g., due to high risk of aspiration, intolerance, gastroparesis). DPEJ may also offer decompression of the gastrointestinal tract in cases of small bowel obstruction (e.g., peritoneal carcinomatosis). Absolute contraindications include active peritonitis, uncorrectable coagulopathy, and ongoing bowel ischemia. Technically, the \u2018pull\u2019 technique using a paediatric colonoscope will be sufficient for most cases. Recent publications demonstrate high rates of technical success (&gt;85%), while patient outcomes do not differ among patients undergoing percutaneous endoscopic gastrostomy (PEG) and those undergoing DPEJ. Obesity is a risk factor for technical failure, while age more than 80\u200ayears, diabetes mellitus, and ongoing inflammatory status may be considered risk factors for DPEJ-associated mortality.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Summary<\/jats:title>\n            <jats:p>DPEJ is a safe and efficacious modality for long-term jejunal nutrition with an acceptable risk of mild complications. Careful patient selection and respect of preprocedural, periprocedural, and postprocedural precautions are of the utmost importance to ensuring a favourable outcome.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/mog.0000000000000828","type":"journal-article","created":{"date-parts":[[2022,3,11]],"date-time":"2022-03-11T15:01:36Z","timestamp":1647010896000},"page":"285-291","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Percutaneous endoscopic jejunostomy: when, how, and when to avoid it"],"prefix":"10.1097","volume":"38","author":[{"given":"Paraskevas","family":"Gkolfakis","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianna","family":"Arvanitakis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2022,3,9]]},"reference":[{"key":"R1-20250729","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.clnu.2019.04.022","article-title":"ESPEN guideline on home enteral nutrition","volume":"39","author":"Bischoff","year":"2020","journal-title":"Clin Nutr"},{"key":"R2-20250729","doi-asserted-by":"crossref","first-page":"1519","DOI":"10.3109\/00365521.2011.619278","article-title":"National survey evaluating service provision for percutaneous endoscopic gastrostomy within the UK","volume":"46","author":"Kurien","year":"2011","journal-title":"Scand J Gastroenterol"},{"key":"R3-20250729","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1016\/j.clnu.2014.10.009","article-title":"Enteral access in adults","volume":"34","author":"Toussaint","year":"2015","journal-title":"Clin Nutr"},{"key":"R4-20250729","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1055\/a-1303-7449","article-title":"Endoscopic management of enteral tubes in adult patients \u2013 Part 1: Definitions and indications. 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