Percutaneous endoscopic gastrostomies: a prospective evaluation and review of the literature

The results of the first 55 consecutive percutaneous endoscopic gastrostomies (PEGs) that were performed over an 18-month period in a tertiary care center are presented. We followed these cases prospectively to assess the morbidity, mortality, staff acceptance, short-and long-term complications, and cost effectiveness of the technique. Fifty-one (93%) were successful with no mortality. Long-term morbidity included 6/55 (11%) tube extrusions; 5/55 (9%) cellulitis around the catheter site; 5/55 (9%) aspiration pneumonias; and 2/55 (3.6%) clogged tubes requiring replacement. Morbidity was considered minor and easily dealt with in all but five instances (9%) where more prolonged treatment was required. A review of the literature including other techniques used for percutaneous gastrostomy is also presented. It is concluded that percutaneous gastrostomies are relatively safe, cost-effective, and should be given first consideration for long-term enteral therapy in appropriate patients.