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Related Experiment Videos

Is repeat endoscopy necessary after percutaneous endoscopic gastrostomy?

Olajide O Odelowo1, Lakshmi Dasaree, Yolanda Hamilton

  • 1Division of Gastroenterology, Department of Medicine, Howard University Hospital, 2041 Georgia Avenue, NW, Washington, D.C. 20060, USA.

Journal of the Association for Academic Minority Physicians : the Official Publication of the Association for Academic Minority Physicians
|October 5, 2002
PubMed
Summary

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Repeat endoscopy is often unnecessary after percutaneous endoscopic gastrostomy (PEG) tube placement. In 93% of cases, initial bumper placement was adequate, suggesting repeat endoscopy should be based on endoscopist discretion for optimal PEG tube positioning.

Area of Science:

  • Gastroenterology
  • Minimally Invasive Procedures
  • Endoscopic Surgery

Background:

  • Percutaneous endoscopic gastrostomy (PEG) is a safe and effective alternative to open gastrostomy for enteral feeding.
  • Two primary PEG techniques exist: Ponsky-Gauderer (pull-string) and Sachs-Vine (push-over-wire).
  • Routine repeat endoscopy is often performed post-PEG to confirm optimal tube and bumper placement.

Purpose of the Study:

  • To evaluate the necessity of repeat endoscopy for confirming optimal percutaneous endoscopic gastrostomy (PEG) tube bumper positioning.
  • To determine the frequency of bumper adjustments during repeat endoscopy after PEG placement.

Main Methods:

  • Retrospective chart review of 132 adult patients undergoing PEG between July 1994 and September 1996.
  • Assessment of whether endoscopists adjusted the PEG tube bumper position during repeat endoscopy.

Related Experiment Videos

  • Categorization of adjustments as minor (< or = 1.0 cm) or major (> 1.0 cm).

    • Main Results:

    • PEG was successful in 125 of 132 patients.
    • Of 110 patients who had repeat endoscopy, 102 (93%) required no bumper adjustment.
    • Minor adjustments were made in 4% and major adjustments in 3% of patients.

    Conclusions:

    • Repeat endoscopy is not routinely required to confirm optimal percutaneous endoscopic gastrostomy (PEG) tube bumper positioning.
    • Initial bumper placement is adequate in the vast majority of cases (93%).
    • Repeat endoscopy should be reserved for cases where the endoscopist suspects improper bumper positioning.