Percutaneous endoscopic gastrostomy experience in a general surgery clinic

Abstract

Background: Percutaneous endoscopic gastrostomy is the most preferable procedure for nutritional support in patients starving for a long time, who have difficulty in swallowing or feeding by oral way due to various diseases. The seven years' experience of this surgery clinic was obtained in this study.

Methods: The indications, complications and long term follow-up were recorded by physicians for 130 patients who had undergone percutaneous endoscopic gastrostomy. We used standart pull method for lite application of gastrostomy.

Results: Percutaneous endoscopic gastrostomy was performed successfully in 82 (63%) chronic neurological patients, 22 (17%) patients with malignancy and 26 (20%) patients with various diseases with especially long time ventilation. It was performed on 93 male and 37 female patients, with a median age of 50.7 years (range 14-90 years). Ninety five (total mortality 73%) patients died because of the primary disease and after being discharged from the hospital. There was no mortality attributable to the procedure. The median time the patients used percutaneous endoscopic gastrostomy was 98.4 days (range 1-518 days) excluding 21 (16%) patients in whom the communication was lost during follow-up. There were a catheter leakage early in 12 and later in 9 patients, unsettled cathether in 8 patients, obstruction in 2 patients and catheter area inflamation in 2 patients. PEG was performed twice in 3 patients.

Conclusion: Percutaneous endoscopic gastrostomy is a safe and reliable procedure for enteral feeding. The important complications are generally related to catheter care. In order to reduce complicatoins in the long run, further education of caretakers of patients and organization of the nutrition outpatient unit is advisable.