{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T09:51:18Z","timestamp":1655977878134},"reference-count":10,"publisher":"FapUNIFESP (SciELO)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Gastroenterol."],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:p> Background Stent palliation is the gold standard for gastric\/duodenal cancer outlet obstruction. When stenting is impossible, feeding may be achieved through a gastrojejunostomy (PEG-J), but displacement of jejunal tube is frequent due to manipulation for feeding and drainage. Gastric outlet obstruction results on increased gastroesophageal reflux or extra-tube leakage. In order to reduce the jejunostomy tube manipulation and the gastric residuum, we created a second gastrostomy (PEG) dedicated to gastric drainage, reducing the PEG-J handling. Objective Our aim was evaluating of the usefulness of an added second gastrostomy in a PEG-J patient, for: 1. controlling symptomatic reflux and extra-tube leakage; 2. preventing jejunal tube dislocation. Methods We retrospectively evaluated patients were stent palliation of gastric\/duodenal cancer outlet obstruction was not achieved, who were referred and underwent PEG-J. We selected four of these patients who needed a second PEG dedicated to gastric drainage, which was performed a few centimetres apart from the gastrojejunostomy. In order to achieve an efficient gastric drainage and provide the maximum comfort to the patient, the drainage PEG tube could be linked to an ileostomy bag. Results The four PEG-J cancer patients with longer survival developed symptoms associated with an important gastric residuum. After the drainage gastrostomy, symptoms subsided or vanished and there were no jejunal tube dislocations. Conclusions When stenting is not possible in patients with gastric\/duodenal outlet obstruction due to cancer growing, feeding PEG-J plus drainage PEG may be an alternative, allowing duodenal\/jejunal feeding and gastric drainage with minimal manipulation of the jejunal tube.<\/jats:p>","DOI":"10.1590\/s0004-28032015000100015","type":"journal-article","created":{"date-parts":[[2017,3,8]],"date-time":"2017-03-08T14:43:38Z","timestamp":1488984218000},"page":"72-75","source":"Crossref","is-referenced-by-count":4,"title":["PERCUTANEOUS ENDOSCOPIC GASTROSTOMY WITH JEJUNAL EXTENSION PLUS PERCUTANEOUS ENDOSCOPIC GASTROSTOMY (PEG-J PLUS PEG) IN PATIENTS WITH GASTRIC\/DUODENAL CANCER OUTLET OBSTRUCTION"],"prefix":"10.1590","volume":"52","author":[{"given":"Jorge","family":"FONSECA","sequence":"first","affiliation":[{"name":"GENE - Grupo de Estudo de Nutri\u00e7\u00e3o Ent\u00e9rica,  Portugal; Instituto Superior de Ci\u00eancias da Sa\u00fade Egas Moniz,  Portugal"}]},{"given":"Carla Adriana","family":"SANTOS","sequence":"additional","affiliation":[{"name":"GENE - Grupo de Estudo de Nutri\u00e7\u00e3o Ent\u00e9rica,  Portugal"}]}],"member":"530","reference":[{"key":"ref1","first-page":"371","article-title":"Nutritional support of patients undergoing radiation therapy for head and neck cancer","volume":"19","author":"Colasanto JM","year":"2005","journal-title":"Oncology (Williston Park)"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1177\/0148607195019003239","article-title":"Percutaneous endoscopic gastrojejunostomy: a dual center safety and efficacy trial","volume":"19","author":"DeLegge MH","year":"1995","journal-title":"JPEN J Parenter Enteral Nutr"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1517\/17425247.2.6.1059","article-title":"Advances in the delivery of treatments for Parkinson\u2019s disease","volume":"2","author":"Johnston TH","year":"2005","journal-title":"Expert Opin Drug Deliv"},{"key":"ref4","first-page":"2638","article-title":"Continuous treatment with levodopa of Parkinson disease (abstract)","volume":"125","author":"Lundqvist C","year":"2005","journal-title":"TidsskrNorLaegeforen"},{"key":"ref5","first-page":"2007","article-title":"The palliative role of percutaneous endoscopic gastrostomy with jejunal extension (PEG-J) in an advanced pancreatic cancer patient with duodenal stenosis-a case report (abstract)","volume":"34","author":"Nakahira S","year":"2007","journal-title":"GanTo Kagaku Ryoho"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1034\/j.1600-0404.2001.00153.x","article-title":"Duodenal levodopa infusion in Parkinson\u2019s disease long-term experience","volume":"104","author":"Nilsson D","year":"2001","journal-title":"Acta Neurol Scand"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1007\/s004640000163","article-title":"Recent experience with percutaneous endoscopic gastrostomy\/jejunostomy (PEG\/J) for enteral nutrition","volume":"14","author":"Simon T","year":"2000","journal-title":"Surg Endosc"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1177\/014860710502900112","article-title":"Effect of jejunal long-term feeding in chronic pancreatitis","volume":"29","author":"Stanga Z","year":"2005","journal-title":"JPEN J Parenter Enteral Nutr"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"150","DOI":"10.4161\/jig.23749","article-title":"Gastroduodenal stents are associated with more durable patency as compared to percutaneous endoscopic gastrojejunostomy in the palliation of malignant gastric outlet obstruction","volume":"2","author":"Strand DS","year":"2012","journal-title":"J Interv Gastroenterol"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1177\/0115426502017005314","article-title":"A retrospective review of the course of patients with pancreatitis discharged on jejunal feedings","volume":"17","author":"Yoder AJ","year":"2002","journal-title":"Nutr Clin Pract"}],"container-title":["Arquivos de Gastroenterologia"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/pdf\/ag\/v52n1\/0004-2803-ag-52-01-72.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2017,5,23]],"date-time":"2017-05-23T00:18:54Z","timestamp":1495498734000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0004-28032015000100015&lng=en&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,3]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2015,3]]}},"alternative-id":["S0004-28032015000100015"],"URL":"https:\/\/doi.org\/10.1590\/s0004-28032015000100015","relation":{},"ISSN":["0004-2803"],"issn-type":[{"value":"0004-2803","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,3]]}}}