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Percutaneous endoscopic gastrostomy
W Sangster1, G D Cuddington, B L Bachulis
1Department of Surgery, Emanuel Hospital and Health Center, Portland, Oregon 97227.
Abstract:
Percutaneous endoscopic gastrostomy has been shown by many investigators to be a safe, rapid means of gaining access to the gastrointestinal tract. Over a 3 1/2 year period, 155 percutaneous endoscopic gastrostomies were performed. All of the patients had an inability to nourish themselves orally. The technique described by Ponsky et al was used. Preoperative antibiotics were administered to 108 patients, and most of the procedures were performed under local anesthesia. Many of the procedures were performed in association with tracheostomies. There were 17 complications (11 percent), including 2 deaths (1 percent). Comparison of percutaneous endoscopic gastrostomy to operative gastrostomy revealed percutaneous endoscopic gastrostomy to be superior. We believe that percutaneous endoscopic gastrostomy should be considered the procedure of choice for tube gastrostomy.
Insights
Percutaneous endoscopic gastrostomy (PEG) is a safe and effective method for gastrointestinal access. This study found PEG to be superior to operative gastrostomy for patients unable to nourish themselves orally.
Area of Science:
- Gastroenterology
- Minimally Invasive Surgery
Background:
- Percutaneous endoscopic gastrostomy (PEG) is a widely accepted procedure.
- Patients requiring nutritional support often face challenges with oral intake.
Purpose of the Study:
- To evaluate the safety and efficacy of PEG.
- To compare PEG with operative gastrostomy.
Main Methods:
- A retrospective review of 155 PEG procedures performed over 3.5 years.
- Utilized the Ponsky et al. technique, with preoperative antibiotics in most cases.
- Procedures often performed under local anesthesia, sometimes concurrently with tracheostomies.
Main Results:
- 155 PEGs were performed on patients with inability to nourish orally.
- 17 complications (11%) occurred, including 2 deaths (1%).
- PEG demonstrated superiority compared to operative gastrostomy.
Conclusions:
- PEG is a safe and rapid method for gastrointestinal access.
- PEG should be considered the preferred method for tube gastrostomy placement.