When push comes to shove: a comparison between two methods of percutaneous endoscopic gastrostomy

Percutaneous endoscopic gastrostomy has supplanted surgical gastrostomy in a number of medical centers. A variety of makeshift or commercially available gastrostomy kits has been used, as have several insertion techniques. Despite widespread use, however, there are conflicting reports regarding the best method of gastrostomy tube insertion. Studying 30 patients, 15 of whom underwent percutaneous endoscopic gastrostomy with the "push" and 15 with the "pull" technique, we found both methods successful, and associated with an acceptable complication rate. In the authors' hands, the "pull" technique was technically easier.