[Endoscopic gastrostomy]

Endoscopic gastrostomy is one procedure that is recommended for feeding or for gastric drainage, when the permanence of the feeding tube is required for a long time. This has arisen as a better alternative than surgical gastrostomy, because of its simplicity, efficiency, lower costs, and scarce morbidity-mortality. The most commonly recommended technique consists of gastric punction by percutaneous route and traction of the feeding tube from the mouth with the aid of an endoscopy. The indications are the necessity of feeding patients in a critical state who have gastric disorders and in whom prolonged gastric suction is required. It is contraindicated in morbid obesity, tension ascites, distension of intestinal loops, gastric carcinoma, pyloric obstruction, liver cirrhosis, previous gastric resective surgery, very voluminous hepatomegaly, and in patients who have had previous high abdominal surgery and who are suspected of having many loop adherences. The procedure may not be carried out when there exists the impossibility of passing the endoscope to the stomach. Complications occur is nearly 5% of the patients, and consist of wound infection due to the dragging of the oropharynx, periostomal leaks, peritonitis, gastrocolic fistulas, and pneumonia by aspiration. Mortality occurs in some 2%.