Percutaneous Endoscopic Gastrostomy with Jejunal Extension Tube for the Delivery of Levodopa Carbidopa Intestinal Gel: Clinical Practice Guidelines of the Romanian Society of Digestive Endoscopy

J Gastrointestin Liver Dis. 2019 Sep 1;28(3):349-354. doi: 10.15403/jgld-404.

Abstract

Percutaneous endoscopic gastrostomy with jejunal extension (PEG/J) was first described in 1998 and has become the standard technique for fixing the tube in place for levodopa carbidopa intestinal gel (LCIG) infusion. The Romanian Society of Digestive Endoscopy (RSDE) decided to create a consensus paper to meet the needs in medical training and practice. After reviewing the available published data and existing recommendations, a consensus process was carried out involving the leaders of opinion in this field. The resulting text and recommendations were approved, after reaching expert consensus, and reflects the views of the RSDE for the best practice of PEG/J tube placement. The pull through method ("pull technique") is the prevailing PEG-tube placement procedure in Romania. The procedure can be performed with intravenous sedation combined with local anesthesia. Although minor complications are common, serious complications are infrequent, and the tube insertion procedures have a good safety record. Redo procedures are sometimes necessary and clinicians should be aware of these situations.

Publication types

  • Practice Guideline
  • Review

MeSH terms

  • Antiparkinson Agents / administration & dosage*
  • Antiparkinson Agents / adverse effects
  • Carbidopa / administration & dosage*
  • Carbidopa / adverse effects
  • Consensus
  • Drug Administration Routes
  • Drug Combinations
  • Drug Compounding
  • Endoscopy, Gastrointestinal / adverse effects
  • Endoscopy, Gastrointestinal / instrumentation*
  • Equipment Design
  • Gastrostomy / adverse effects
  • Gastrostomy / instrumentation*
  • Gels
  • Humans
  • Infusion Pumps
  • Jejunum / surgery*
  • Levodopa / administration & dosage*
  • Levodopa / adverse effects
  • Parkinson Disease / diagnosis
  • Parkinson Disease / drug therapy*
  • Treatment Outcome

Substances

  • Antiparkinson Agents
  • Drug Combinations
  • Gels
  • carbidopa, levodopa drug combination
  • Levodopa
  • Carbidopa