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Percutaneous endoscopic gastrostomy tube placement via the introducer technique is safe and effective in children

Kyle J Glithero1,2, Matthew T Hey3,4, Juan L Calisto3

  • 1Department of Pediatric Surgery, Nicklaus Children's Hospital, 3100 S.W. 62nd, Avenue, Miami, FL, 33155, USA. kjglithero@gmail.com.

Pediatric Surgery International
|September 26, 2022
PubMed

Insights

Percutaneous endoscopic gastrostomy (PEG) introducer technique is faster and cheaper than laparoscopic gastrostomy (LapGT) in children. When safety criteria are met, PEG reduces operative time and cost without compromising patient safety.

Area of Science:

  • Pediatric surgery
  • Gastroenterology
  • Minimally invasive procedures

Background:

  • Gastrostomy tubes are essential for nutritional support in pediatric patients.
  • Both percutaneous endoscopic gastrostomy (PEG) and laparoscopic gastrostomy (LapGT) are established methods for tube placement.
  • Comparing the efficiency and safety of these techniques is crucial for optimizing patient care.

Purpose of the Study:

  • To compare the outcomes of percutaneous endoscopic gastrostomy (PEG) introducer technique versus laparoscopic gastrostomy (LapGT) in a pediatric setting.
  • To evaluate differences in procedure time, operative charges, and 30-day complications between the two techniques.
  • To determine the safety and efficacy of the PEG introducer technique in pediatric patients.

Main Methods:

  • A retrospective review of isolated PEG and LapGT placements from August 2016 to January 2018.
  • Comparison of demographics, procedure time, operative charges, and 30-day complications.
  • Statistical analysis using the student's t test for quantitative data and the X2 test for categorical data.

Main Results:

  • Ninety-three gastrostomy tubes were placed (56 PEG, 37 LapGT).
  • PEG procedures were significantly shorter (14 vs. 33 minutes, p < 0.001) and less costly (average $4500 less).
  • No significant difference in 30-day complications or fundoplication rates; two PEGs were converted to LapGTs.

Conclusions:

  • The PEG introducer technique is a safe and effective alternative to LapGT in pediatric patients.
  • Utilizing PEG with defined safety criteria significantly reduces operative time and costs.
  • PEG placement offers comparable safety outcomes to LapGT, making it a cost-effective option.
Abstract

Keywords:
GastrostomyLaparoscopicPEGPediatric

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