{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T21:23:40Z","timestamp":1761513820732},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,2,1]],"date-time":"2017-02-01T00:00:00Z","timestamp":1485907200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2017,2,1]],"date-time":"2017-02-01T00:00:00Z","timestamp":1485907200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["UEG Journal"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Continuous delivery to the jejunum of levodopa\u2010carbidopa is a promising therapy in patients with advanced Parkinson\u2019s disease, as it reduces motor fluctuation. Percutaneous endoscopic gastrostomy and jejunal tube (PEG\u2010J) placement is a suitable option for this. However, studies focused in PEG\u2010J management are lacking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We report our experience regarding this technique, including technical success, adverse events and outcomes, in patients with advanced Parkinson\u2019s disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty\u2010seven advanced Parkinson\u2019s disease patients (17\u00a0men, median age: 64 years, median disease duration: 11 years) were included in a retrospective study from June 2007 to April 2015. The median follow\u2010up period was 48\u00a0months (1\u201396).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>No adverse events were noted during and after nasojejunal tube insertion (to assess treatment efficacy). After a good therapeutic response, a PEG\u2010J was placed successfully in all patients. The PEG tube was inserted according to Ponsky\u2019s method. The jejunal extension was inserted during the same procedure in all patients. Twelve patients (44%) experienced severe adverse events related to the PEG\u2010J insertion, which occurred after a median follow\u2010up of 15.5\u00a0months. Endoscopy was the main treatment modality. Patients who experienced severe adverse events had a higher comorbidity score (<jats:italic>p<\/jats:italic> \u2009=\u20090.011) but were not older (<jats:italic>p<\/jats:italic> \u2009=\u20090.941) than patients who did not.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>While all patients responded well to levodopa\u2010carbidopa regarding neurological outcomes, gastro\u2010intestinal severe adverse events were frequent and related to comorbidities. Endoscopic treatment is the cornerstone for management of PEG\u2010J related events. In conclusion, clinicians and endoscopists, as well as patients, should be fully informed of procedure\u2010related adverse events and patients should be followed in centres experienced in their management.<\/jats:p><\/jats:sec>","DOI":"10.1177\/2050640616650804","type":"journal-article","created":{"date-parts":[[2016,5,20]],"date-time":"2016-05-20T09:52:47Z","timestamp":1463737967000},"page":"60-68","update-policy":"http:\/\/dx.doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["The use of enteral access for continuous delivery of levodopa\u2010carbidopa in patients with advanced Parkinson\u2019s disease"],"prefix":"10.1002","volume":"5","author":[{"given":"Julian","family":"Cheron","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Hepatopancreatology and GI Oncology Erasme University Hospital Universit\u00e9 Libre de Bruxelles Brussels Belgium"},{"name":"Department of Neurology Erasme University Hospital 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