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Related Experiment Videos

Gastrostomy insertion: comparing the options--PEG, RIG or PIG?

H-U Laasch1, L Wilbraham, K Bullen

  • 1Academic Department of GI-Radiology, South Manchester University Hospitals NHS Trust and University of Central Lancashire, Manchester, UK. hul@smtr.nhs.uk

Clinical Radiology
|May 3, 2003
PubMed
Summary

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Per-oral image-guided gastrostomy (PIG) offers higher success and fewer re-interventions than percutaneous endoscopic gastrostomy (PEG) or radiologically inserted gastrostomy (RIG). This hybrid technique is effective, especially when conventional PEG fails.

Area of Science:

  • Gastroenterology
  • Interventional Radiology
  • Medical Device Technology

Background:

  • Percutaneous endoscopic gastrostomy (PEG) and radiologically inserted gastrostomy (RIG) are common methods for enteral feeding access.
  • Limitations exist for both PEG (e.g., detecting pathology) and RIG (e.g., tube blockage).

Purpose of the Study:

  • To compare the efficacy and outcomes of PEG and RIG.
  • To evaluate a novel hybrid technique, per-oral image-guided gastrostomy (PIG).

Main Methods:

  • Prospective comparison of 50 PEGs and 50 RIGs across three centers.
  • Review of endoscopic findings in 200 PEGs.
  • Implementation and assessment of a modified fluoroscopy-guided PIG technique in 60 patients.

Main Results:

Related Experiment Videos

  • Technical success rates were high: 98% (PEG), 100% (RIG), and 100% (PIG).
  • PIG demonstrated a significantly lower re-intervention rate (0%) compared to PEG (12%) and RIG (20%).
  • PIG was successful in cases where conventional PEG failed, and endoscopic findings were primarily limited to peptic disease.

Conclusions:

  • Per-oral image-guided gastrostomy (PIG) combines the advantages of PEG and RIG, offering superior success and reduced re-intervention rates.
  • PIG provides better long-term results than RIG and is a viable alternative when PEG is not feasible.
  • Endoscopic evaluation during PEG is unlikely to reveal clinically significant pathology beyond peptic disease.