Percutaneous Endoscopic Gastrostomy Tube Placement: A Single Center Experience
12 December 2019 (online)
Introduction Percutaneous endoscopic gastrostomy (PEG) tube placement is one of the recommended methods for providing enteral feeding in patients with swallowing difficulty and intact gastrointestinal tract. We review our three years of experience pertaining to PEG placement in our hospital.
Methods Records of all the patients, who underwent PEG between May 2014 to September 2017, were reviewed and relevant clinical and procedural details were noted. For all the patients, the procedure was conducted under antibiotic prophylaxis, moderate sedation, and local anesthesia. The PEG tube was placed by the “pull up” method. Telephonic follow-up of the patients was carried out after one month of study completion.
Results The PEG tube was placed in 73 patients (male 51 [69.9%]; age median [range] 67 [16–91] years). PEG was placed in 42 patients with stroke (57.6%), other neurologic disorders 17 (23.3%), coma due to head injury 5 (6.8%), and terminal malignancy 9 (12.3%). Technical success was achieved in 73 (97%) patients. Eleven procedure-related complications occurred in nine patients (15.5%) including one death due to peritonitis. Of the 57 patients, who could be followed-up after discharge, 41 died of their primary illness after 65 (1–751) days, nine were alive and continuing on PEG tube feed, and in seven PEG was removed because it was not needed.
Conclusion PEG is a useful procedure for enteral feeding. Although procedural success is high, it may be accompanied by significant complications.
- 1 Gauderer MW, Ponsky JL, Izant RJ Jr. Gastrostomy without laparotomy: a percutaneous endoscopic technique. J Pediatr Surg 1980; 15 (06) 872-875
- 2 Tang SJ, Wu R. Percutaneous endoscopic gastrostomy (pull method) and jejunal extension tube placement. Video J Encycl GI Endosc 2014; 2 (01) 40-45
- 3 Lipp A, Lusardi G. Systemic antimicrobial prophylaxis for percutaneous endoscopic gastrostomy. Cochrane Database Syst Rev 2013; (11) CD005571
- 4 Banerjee S, Shen B, Baron TH. et al. ASGE STANDARDS OF PRACTICE COMMITTEE. Antibiotic prophylaxis for GI endoscopy. Gastrointest Endosc 2008; 67 (06) 791-798
- 5 Magné N, Marcy PY, Foa C. et al. Comparison between nasogastric tube feeding and percutaneous fluoroscopic gastrostomy in advanced head and neck cancer patients. Eur Arch Otorhinolaryngol 2001; 258 (02) 89-92
- 6 Sadasivan A, Faizal B, Kumar M. Nasogastric and percutaneous endoscopic gastrostomy tube use in advanced head and neck cancer patients: a comparative study. J Pain Palliat Care Pharmacother 2012; 26 (03) 226-232
- 7 Enestvedt BK, Jorgensen J, Sedlack RE. et al. ASGE Training Committee 2013-2014. Endoscopic approaches to enteral feeding and nutrition core curriculum. Gastrointest Endosc 2014; 80 (01) 34-41
- 8 Wiesen AJ, Sideridis K, Fernandes A. et al. True incidence and clinical significance of pneumoperitoneum after PEG placement: a prospective study. Gastrointest Endosc 2006; 64 (06) 886-889
- 9 Mansoor H, Masood MA, Yusuf MA. Complications of percutaneous endoscopic gastrostomy tube insertion in cancer patients: a retrospective study. J Gastrointest Cancer 2014; 45 (04) 452-459
- 10 Naik RP, Joshipura VP, Patel NR, Haribhakti SP. Complications of PEG–prevention and management. Trop Gastroenterol 2009; 30 (04) 186-194