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One-step Percutaneous Gastrojejunostomy in Early Infancy

Michaud, Laurent; Robert-Dehault, Amélie; Coopman, Stéphanie; Guimber, Dominique; Turck, Dominique; Gottrand, Frédéric

Journal of Pediatric Gastroenterology & Nutrition: June 2012 - Volume 54 - Issue 6 - p 820–821
doi: 10.1097/MPG.0b013e31824d970f
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ABSTRACT: In certain conditions that obviate the use of gastric feedings, the insertion of a jejunal feeding tube via gastrostomy constitutes an alternative to jejunostomy but requires a preexisting gastrostomy. Our aim was to assess a new technique of 1-step gastrojejunal tube insertion through a de novo gastrostomy. A total of 3 infants between 3 and 7 months old and weighing between 4.1 and 5.4 kg had a gastrojejunal feeding tube inserted using a 16-CH French introducer percutaneous endoscopic gastrostomy kit and a transgastric-jejunal feeding tube. No technical difficulties occurred and the gastrojejunal feeding tube was placed successfully in the 3 patients, the total procedure lasting 15 to 20 minutes. Enteral feeding was started within 4 to 6 hours of the procedure. Neither immediate (<24 hours) nor late complications related to the gastrojejunostomy occurred. Nissen fundoplication was performed in 2 of our patients at 12 and 15 months of age, respectively. The gastrojejunostomy tube was still in place in the third patient at age 15 months. Our first experience suggests that 1-step endoscopic placement of a transgastric-jejunal feeding tube without a preexisting gastrostomy tract is feasible in young and low-weight infants.

Division of Gastroenterology, Hepatology and Nutrition, and Reference Centre for Congenital and Malformative Oesophageal Diseases, Department of Paediatrics, Jeanne de Flandre Children's Hospital and Faculty of Medicine, University Lille 2, Lille, France.

Address correspondence and reprint requests to Laurent Michaud, MD, Département de Pédiatrie, Unité de Gastro-entérologie, Hépatologie et Nutrition, Hôpital Jeanne de Flandre, Avenue Eugène Avinée, 59037 Lille, France (e-mail:

Received 5 December, 2011

Accepted 30 January, 2012

The authors report no conflicts of interest.

Copyright 2012 by ESPGHAN and NASPGHAN