Evaluating gastric emptying in pediatric patients with prior gastrostomy: A retrospective cohort study

Gastrostomy tube placement is a common intervention for pediatric patients requiring long-term enteral feeding, yet the clinical profile and rates of gastric emptying in such population is poorly described. This study aimed to compare the clinical profile, subsequent gastric emptying, and diagnostic rates of gastroparesis in patients with and without prior gastrostomy.

This retrospective study included pediatric patients <18 years undergoing gastric emptying scintigraphy (GES) at a quaternary care center between 2016 and 2020. The variable of interest was prior gastrostomy, defined as percutaneous endoscopic gastrostomy (PEG) or surgical gastrostomy. The primary outcome was gastric half-emptying time (T1/2), with secondary outcomes including gastric retention rates at 1, 1.5, and 2 h, and gastroesophageal reflux (GER) on GES. Statistical analyses included chi-square, Fisher's exact, and Mann-Whitney U tests.

Of 238 pediatric patients undergoing GES, 59 (24.8%) had prior gastrostomy (50 PEG, 9 surgical). Patients with gastrostomy were younger (p < 0.001), more often male (p = 0.003), and more likely to undergo liquid GES (p < 0.001). There were no significant differences in gastroparesis diagnostic rates (p = 0.836) or T1/2 between patients by gastrostomy status. However, patients with gastrostomy demonstrated significantly higher rates of GER on GES (32.8% vs. 16.7%, p = 0.009).

In one of the largest observational cohort studies of pediatric patients with gastrostomy tubes, gastric emptying rates did not differ by prior gastrostomy status. Prospective studies are needed to determine whether a causal relationship exists between gastrostomy placement and altered gastric emptying.