Endoscopic sphincterotomy assisted by catheterization antegrade

Salky described a technique for gastrostomy-jejunostomy conversion which employs fluroscopy and a J -wire to thread the feeding tube into the proximal small intestine. With the use of the gastroscope, the feeding tube is simply and readily positioned in the duodenum. A similar endoscopic technique has been described by Bernton et a1. for placement of rectal tubes with the aid of the colonoscope. Introduction of the feeding tube through the gastrostomy avoids the discomfort and complications associated with tubes placed through the nose. In addition, the feeding tube can be easily maintained in position while the gastroscope is withdrawn through the pylorus. The introduction of the gastroscope and a feeding tube, beside one another and through the esophagus, frequently results in dislodgment of the feeding tube when the 'scope is withdrawn.