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Complications of percutaneous endoscopic gastrostomy
1Department of Surgery L, University Hospital of Aarhus, Denmark.
Objective:
To report our experience of percutaneous endoscopic gastrostomy with particular reference to complications and tube dysfunction.
Design:
Retrospective study.
Setting:
Teaching hospital, Denmark.
Subjects:
135 patients who required 178 gastrostomy tubes between 1.1.1990 and 30.6.1994.
Intervention:
101 patients had the tubes inserted by the introducer technique and 34 by the pull-through method.
Main Outcome Measures:
Complications and incidence of tube dysfunction.
Results:
The overall complication rate was 43/135 (32%), including tube dysfunction; 17 (13%) developed a serious complication (intraperitoneal leakage, wound infection, or subcutaneous emphysema) and 6 died (4%). In each case the introducer had been used. 28 patients (21%) had a non-functioning tube exchanged sometimes more than once. The mean life-span of the tubes were 3.8 months, and seemed to be independent of the technique chosen for introduction. 66 patients (49%) died with a functioning tube. 24 (18%) died within a month of the insertion.
Conclusion:
serious complications leading to laparotomy, wound infection, or intraperitoneal abscess developed in 17 patients (13%), in all of whom the introducer technique had been used. The safer pull-through technique is therefore recommended.