Gastrostomy and jejunostomy: aspects of the technical evolution and widening of indications

Abstract

A temporary or permanent access to the stomach or jejunum, through a gastrostomy or jejunostomy, isindicated whenever nutritional support or prolonged decompression of the upper alimentary tract isneeded.  With the introduction of endoscopic gastrostomy, the utilization of these procedures has increased in the last 25 years, specially in patients with progressive neurologic diseases and in those withadvanced cancer.  This article deals with the conceptual aspects of gastrostomies and jejunostomies, itsprimary indications, the preferential means of access in different clinical scenarios as well as the technical modalities most frequently used.  The management of the stomas, the results and potential complications are also highlighted. Finally, the ethical and legal implications of greater utilization of theseprocedures in a palliative setting are also discussed.