Effectiveness of decompression catheter placement through direct percutaneous endoscopic jejunostomy (DPEJ) into the remnant stomach for a case of impaired gastric drainage after distal gastrectomy

Abstract

A woman in her 70s who had undergone distal gastrectomy for gastric cancer suffered with oral intake, thus direct percutaneous endoscopic jejunostomy (DPEJ) was performed. However, as repeated vomiting of gastric juices and feeding materials occurred after initiating jejunal feeding, we changed the feeding site to 40 cm distal from the initial jejunostomy stoma by deploying a PEG-jejunal extension (PEG-J) tube. Since vomiting of gastric contents continued, an additional DPEJ was performed on an afferent loop and the tip of the catheter was placed in the residual stomach to drain the gastric contents. After this procedure, the patient rarely vomited and jejunal feeding was successfully re-started. It is suggested that decompression catheter placement from an afferent loop into the stomach is effective for cases which suffer impaired gastric drainage from the remnant stomach following partial gastrectomy.