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Comparison of Complications Following Laparoscopic and Endoscopic Gastrostomy Placements

Sara L Zettervall1, Jeremy L Holzmacher2, Michal Radomski2

  • 1Department of Surgery, George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Ave. NW, Suite 6B, Washington, DC, 20037, USA. slzettervall@gmail.com.

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
|June 30, 2017
PubMed

Insights

Laparoscopic gastrostomy (LG) placement is as safe as percutaneous endoscopic gastrostomy (PEG) placement in adults, even with higher patient comorbidities. Further research should identify predictors for superior LG outcomes in specific patient groups.

Area of Science:

  • Gastroenterology
  • Surgical Procedures
  • Medical Device Placement

Background:

  • Enteral access is crucial for patients unable to tolerate oral feeds.
  • Percutaneous endoscopic gastrostomy (PEG) and laparoscopic gastrostomy (LG) are common methods for enteral access.
  • Limited comparative data exists for PEG versus LG outcomes in adult populations.

Purpose of the Study:

  • To compare complication rates between PEG and LG placements in adult patients.
  • To identify factors influencing outcomes in patients undergoing gastrostomy procedures.

Main Methods:

  • Retrospective chart review of 224 adult patients (164 PEG, 60 LG) from 2007-2014.
  • Comparison of patient demographics, comorbidities, and Charlson Comorbidity Index (CCI).
  • Logistic regression analysis to determine predictors of complications.

Main Results:

  • LG patients had higher rates of prior surgery and age-adjusted CCI.
  • Return to operating room was more frequent after PEG (5.5%) than LG (0%), though not statistically significant.
  • No difference in 30-day mortality; however, higher CCI predicted mortality.

Conclusions:

  • Laparoscopic gastrostomy (LG) demonstrates comparable safety to percutaneous endoscopic gastrostomy (PEG), despite higher patient comorbidity.
  • Further research is needed to identify patient-specific factors that may predict superior outcomes with LG placement.
  • Optimizing patient selection for LG could enhance post-operative outcomes.
Abstract

Keywords:
Endoscopic gastrostomyGastrostomyLaparoscopic gastrostomyPEG

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