Published online Oct 16, 2022. doi: 10.4253/wjge.v14.i10.616
Peer-review started: June 6, 2022
First decision: August 1, 2022
Revised: August 5, 2022
Accepted: October 4, 2022
Article in press: October 4, 2022
Published online: October 16, 2022
LJG, when initially described, was used as one of the first-line enteral access options, and has since been replaced by the advent and popularity of PEG. The significance of this study is that it demonstrates that the laparoscopic modification may be an acceptable first-line procedure for specific indications due to its longevity and ease of completion.
The main topics of this paper are that LJG may have more clinical relevance than previously considered. The problems this paper addresses is the complication rate including those caused due to dislodgement and tube removal with the PEG procedure. This procedure ameliorates these complications and may have a role in first-line access for specific indications.
The main objectives of this project was to describe cases of LJG as well as perform a systematic review of the available data as it relates to LJG for enteral access. We realized from this review, that LJG may serve as a viable alternative to PEG as a first-line option for enteral access in specific populations. The significance of this realization can result in lower morbidity and mortality as it relates to the complications of PEG dislodgements in specific patient populations.
A systematic review was performed of all available data of LJG relating to use for enteral access. This data was analyzed by the reviewers to realize the objectives. To our knowledge, no large systematic reviews of LJG have been recently performed for this purpose.
Our findings describe relatively low rate of complications from LJG, largely as a result of the permanent gastrostomy tube formed in the procedure. We also note significant technical ease in completion of the procedure.
This study proposes that LJG may be a viable alternative to PEG as a first-line procedure in specific patient populations.
This study describes the laparoscopic modification of Janeway gastrostomy and notes the technical ease and reproducibility.
The direction for future research in this topic may include prospective studies and randomized controlled trials to determine true comparative data between LJG and PEG and other gastrostomy alternatives, and also to provide objective data to guide optimal patient selection.