Complications Post Gastrostomy Insertion in Patients with Head and Neck Cancer: A Systematic Review

Percutaneous endoscopic gastrostomy (PEG) or radiologically inserted gastrostomy (RIG) placement can result in adverse events. The aim of this study was to update the systematic literature review on complications following gastrostomy placement in head and neck cancer (HNC).

PubMed, CINAHL, and EMBASE databases were searched for full-text articles published 2008-2025. Empirical studies reporting gastrostomy complications in adult patients with HNC were included. Complications were classified as severe or mild adverse events. Risk of bias and certainty of evidence were assessed.

Twenty‑five studies reported on 4854 procedures (n = 3670 PEG; n = 1184 RIG). Median procedure-related mortality and severe complications were <1%. Severe complications requiring treatment or hospital admission were 1% for both PEG and RIG. Severe infections were <1% in PEG and 1% in RIG.

Gastrostomy insertion is safe with minimal differences between PEG and RIG. Insertion technique should be dependent on clinical indication, clinician expertise and hospital resources.