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Complications of percutaneous endoscopic and radiologic gastrostomy tube insertion: a KASID (Korean Association for the Study of Intestinal Diseases) study

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Abstract

Background

Gastrostomy tube insertion is beneficial to selected patients, and percutaneous endoscopic gastrostomy (PEG) and percutaneous radiological gastrostomy (PRG) are two of the frequently used methods in gastrostomy. This study aimed to investigate the indications and complications of both PEG and PRG.

Methods

This was a retrospective multicenter cohort study. Patients who underwent initial PEG or PRG tube insertion for nutritional purpose between January 2010 and December 2015 at five university hospitals were included in the study. We analyzed the indications and all complications related to gastrostomy, which were divided into the major (systemic or life-threatening) and minor (local and non-life-threatening) categories.

Results

A total of 418 patients who underwent PEG (n = 324) and PRG (n = 94) were reviewed. The indications for gastrostomy tube insertion were different and included mainly neurological disease (n = 240, 74.1%) such as cerebrovascular accident in the PEG group (n = 119, 36.7%) and mainly surgical disease (n = 28, 29.8%) such as head and neck cancer (n = 16, 17.0%) in the PRG group (p = 0.05). There were no differences in the minor (16.4% vs. 19.1%, p = 0.52) and major (12.3% vs. 14.9%, p = 0.51) complication rates between the PEG and PRG groups. The risk factors for complications were age [yearly increments; odds ratio (OR) 1.03, 95% confidence interval (CI) 1.01–1.06], tube diameter (1-Fr increments; OR 1.26, 95% CI 1.01–1.58), insertion time (1-min increments; OR 1.07, 95% CI 1.01–1.13), and neurological disease as the gastrostomy indication (vs. surgical disease; OR 4.61 95% CI 1.47–14.42).

Conclusions

In our study, both PEG and PRG provided a safe route for nutrition delivery despite their different indications. Our data suggest that PEG might be the procedure of choice for patients with medical or neurological disease and PRG for patients with surgical disease in whom PEG is technically difficult or contraindicated.

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Author notes

  1. Soo-Kyung Park and Ji Yeon Kim are co-first authors.

Authors and Affiliations

  1. Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 031811, South Korea

    Soo-Kyung Park

  2. Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea

    Ji Yeon Kim & Soo Jung Park

  3. Department of Internal Medicine, Seoul University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea

    Seong-Joon Koh

  4. Division of Gastroenterology, Department of Internal Medicine, Keimyung University School of Medicine, 56 Dalseong-ro, Jung-gu, Daegu, 41931, South Korea

    Yoo Jin Lee

  5. Division of Gastroenterology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, 7 Keunjaebong-gil, Hwaseong-si, Gyeonggi-do, 18450, South Korea

    Hyun Joo Jang

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  1. Soo-Kyung Park
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Consortia

Small Intestine and Nutrition Research Group of the Korean Association for the Study of Intestinal Diseases (KASID)

Corresponding author

Correspondence to Soo Jung Park.

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Disclosure

Soo-Kyung Park, Ji Yeon Kim, Seong-Joon Koh, Yoo Jin Lee, Hyun Joo Jang, and Soo Jung Park have no conflicts of interest or financial ties to disclose.

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Park, SK., Kim, J.Y., Koh, SJ. et al. Complications of percutaneous endoscopic and radiologic gastrostomy tube insertion: a KASID (Korean Association for the Study of Intestinal Diseases) study. Surg Endosc 33, 750–756 (2019). https://doi.org/10.1007/s00464-018-6339-1

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  • DOI: https://doi.org/10.1007/s00464-018-6339-1

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