Optimal management of gastrojejunal tube in the ENFit era – interventions that changed practice

Abstract Background We experienced a high incidence of jejunal tube (JEJ) displacement in children who underwent percutaneous endoscopic transgastric jejunostomy (PEGJ), ever since the introduction of ENFit connector (2017). Methods Two interventions were introduced in 2018 – fixative suture to PEGJ ENFit connector, and conversion to balloon transgastric-jejunal feeding device (Balloon GJ) whenever possible. Children receiving PEGJ and Balloon GJ in 2.8 years were categorized into 3 eras: 2016 (pre-ENFit), 2017 (ENFit) and 2018 (interventional), for comparison of complications and sequelae. Kaplan–Meier survival curves with log-rank test (P  Results 100 children underwent 323 JEJ insertions – PEGJ (n = 237), Balloon GJ (n = 86). Complications occurred in 188 JEJ (42%), more frequently with PEGJ than Balloon GJ (69% vs. 29%, P  Conclusions Balloon GJ had better overall outcomes than PEGJ. Suture application to connector successfully reduced JEJ internal displacement in PEGJ, however conversion to Balloon GJ should be strongly considered. Level of evidence. II