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Percutaneous endoscopic gastrostomy. New technique--old complications.
C Steffes1, D W Weaver, D L Bouwman
1Wayne State University School of Medicine, Department of Surgery, Detroit, MI 48201.
The American Surgeon
|May 1, 1989
Summary
Percutaneous endoscopic gastrostomy (PEG) offers a successful and safe alternative to traditional gastrostomy. This procedure facilitates early patient transfer, even for critically ill individuals.
Area of Science:
- Gastroenterology
- Minimally Invasive Surgery
Background:
- Percutaneous endoscopic gastrostomy (PEG) is increasingly recognized as a viable alternative to open gastrostomy.
- Early reports suggest PEG offers advantages in cost and ease of placement with reduced complications.
Purpose of the Study:
- To evaluate the efficacy and safety of PEG as an initial procedure in a broad patient population.
- To assess the complication rates and success of PEG in adult patients.
Main Methods:
- Retrospective review of 115 PEG placements in 112 adult patients over 32 months.
- Analysis of procedure success rates, complication types, and 30-day mortality.
Main Results:
- PEG placement was successful in 84% of patients, with 10% failure and 6% difficulty.
- Minor complications occurred in 9.5%, major complications in 20%, with infection being most common.
- 30-day mortality was 24%, with no direct procedure-related deaths.
Conclusions:
- PEG can be safely employed as an initial procedure, even in critically ill patients, achieving high success rates.
- Morbidity associated with PEG is comparable to open gastrostomy.
- Early PEG placement facilitates patient transition to non-acute care settings.