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La gastrostomie percutanée endoscopique: techniques et expériences personnelles

Percutaneous endoscopic gastrostomy: methods and personal findings

  • Published:
Acta Endoscopica

Résumé

La voie d’entrée alternative idéale pour l’alimentation entérale doit être d’exécution simple, sûre, réversible, peu onéreuse et facile à gérer. La gastrostomie endoscopique percutanée (GEP) satisfait à ces conditions.

Entre juillet 1989 et avril 1995, nous avons placé 254 prothèses endo-gastriques (PEG).

Nous avons utilisé et comparé les techniques «pull, push et introducer» et des modèles différents de prothèses.

Le taux de succès a été de 98,1 %.

La durée moyenne de l’intervention a été de 12 minutes.

Nous n’avons pas eu de décès et seulement trois complications graves (1,2%): 1 hémorragie massive, 1 péritonite, 1 buried bumper syndrome.

Les complications mineures (17,7 %) ont été: pneumopéritoine (1,2 %), infections péristomales (2,8 %), buried bumper syndrome (0,4 %), mécaniques (4,7 %), reflux gastro-œsophagien (3,5 %), diarrhée (4,7 %) et ralentissement de la vidange gastrique (0,4 %).

L’extraordinaire succès rencontré par la méthode aux USA (où ont été mises en place plus d’1 000 000 de PEG et 310 000 kits vendus en 1994), a gagné l’Europe où en Allemagne et en Italie on été vendus respectivement 143 000 et 12 000 kits.

Summary

The ideal technique for feeding access to the digestive tract should be easy, safe, reversible, cost-effective and of simple management. Percutaneous endoscopic gastrostomy (PEG) has all these qualities.

Between July 1989 and April 1995, 254 patients underwent PEG placement. We used and compared different prosthesis and procedures (push, pull and introducer).

The success rate was 98.1 %. The mean duration of the procedure was 12 minutes. We had no deaths. Three major complications (1 massive bleeding, 1 buried bumper syndrome, 1 peritonitis) occurred.

The minor complications (17.7 %) were: pneumoperitoneum (1.2 %), wound infections (2.8 %), buried bumper syndrome (0.4 %), mechanical (4.7 %), gastro-esophageal reflux (3.5 %), diarrhoea (4.7 %) and impaired gastric emptying (0.4 %).

The amazing success of PEG in USA, where more than 1 000 000 PEGs were placed and 310 000 kits were sold in 1994, has spread to Europe where in Germany and in Italy 143 000 and 12 000 kits were sold respectively.

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Author notes

  1. M. Del Piano

    Present address: Servizio di Gastroenterologia ed Endoscopia Digestiva, Ospedale Maggiore di Novara, Corso Mazzini, 18, 28100, Novara, Italie

Authors and Affiliations

  1. Servizio di Gastroenterologia ed Endoscopia Digestiva, Ospedale Maggiore di Novara, Corso Mazzini, 18, 28100, Novara, Italie

    F. Montino, P. Occhipinti & F. D’Andrea

  2. Service de Nutrition, Novara, Italie

    F. D’Andrea

Authors
  1. M. Del Piano
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  2. F. Montino
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  3. P. Occhipinti
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  4. F. D’Andrea
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Del Piano, M., Montino, F., Occhipinti, P. et al. La gastrostomie percutanée endoscopique: techniques et expériences personnelles. Acta Endosc 25, 239–246 (1995). https://doi.org/10.1007/BF02963506

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