Percutaneous endoscopic gastrostomy after abdominal surgery

Percutaneous endoscopic gastrostomy (PEG) has been established as a minimally invasive and safe procedure to provide nutritional support in patients unable to swallow food properly. However, a relative contraindication for the procedure is the existence of previous abdominal surgery.

We described our experience in performing PEG on 37 patients who had undergone surgery for upper abdominal diseases 10 days to 25 years previously. This group of 37 patients, 22 of whom had been subjected to laparotomy in the previous 2 weeks, was compared with 291 patients who had an intact abdomen regarding failure of the procedure to be performed, major and minor complications, and mortality.

The two groups were found to be comparable: failure rates of 2.71% (1/37) and 1.72% (5/291), no major complications, no mortality, minor complication rates of 2.77% (1/36) and 2.44% (7/286).

The PEG procedure is associated with minimal risk even in patients previously subjected to upper abdominal surgery, as long as transillumination of the stomach and finger palpation are seen clearly during endoscopy.