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Gastropexy device impaction in children with push percutaneous endoscopic gastrostomy

Juliette Viart1,2, Matthieu Antoine3, Madeleine Aumar3,4

  • 1Pediatric Gastroenterology Hepatology and Nutrition Department, Jeanne de Flandre Hospital, CHU Lille, Univ. Lille, Lille, 59000, France. jviart@ch-tourcoing.fr.

Scientific Reports
|October 3, 2025
PubMed

Insights

T-bar retention is common after one-step button percutaneous endoscopic gastrostomy (B-PEG) in children. Younger age increases the risk, suggesting early T-fastener removal may prevent gastropexy complications.

Area of Science:

  • Pediatric Gastroenterology
  • Minimally Invasive Surgery
  • Medical Device Complications

Background:

  • One-step button percutaneous endoscopic gastrostomy (B-PEG) is a widely used gastrostomy placement technique.
  • Complications associated with T-fasteners used in B-PEG are not well-documented.
  • T-bar retention can lead to gastropexy-related issues.

Purpose of the Study:

  • To determine the incidence of T-bar retention after B-PEG in pediatric patients.
  • To identify risk factors associated with T-bar retention.
  • To evaluate the clinical implications of T-bar retention.

Main Methods:

  • Retrospective analysis of 679 children undergoing B-PEG between 2009 and 2020.
  • Review of patient characteristics, comorbidities, and complications.
  • Analysis of radiological examinations to assess T-bar impaction at least 6 weeks post-procedure.

Main Results:

  • T-bar impaction was observed in 74.7% of 483 analyzed patients.
  • Younger age at the time of B-PEG was a significant risk factor for T-bar impaction (OR: 2.82, P < .0001).
  • The median time to the first radiological examination showing T-bar impaction was 0.55 years.

Conclusions:

  • A high incidence of T-bar impaction occurs after pediatric B-PEG.
  • Younger children are at increased risk for T-bar retention.
  • Early discussion regarding T-fastener removal post-B-PEG is recommended to mitigate gastropexy complications.

Keywords:
ChildrenGastrostomyImpactionPersistenceT-barT-fasteners

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