Skip to main content
SpringerLink
Log in

La gastrostomie percutanée endoscopique chez l’enfant

Percutaneous endoscopic gastrostomy in children

  • Published:
Acta Endoscopica

Résumé

Durant une période de 3 ans, 28 enfants âgés de 7±5 ans et pesant 18 ± 10 kg ont bénéficié d’une gastrostomie percutanée endoscopique (GPE) par la technique du pull au C.H.R.U. de Lille. Dix-huit enfants présentaient une pathologie neurologique (62 %) et 6 une mucoviscidose (21 %). Des incidents techniques ont été notés chez 11 enfants: nécessité de plusieurs ponctions gastriques (n=8) ou d’un découpage de la collerette de la sonde (n=3). Vingt complications ont été observées chez 12 enfants: infections cutanées (n=7), pneumopathies (n=6), iléus (n=2), pneumopéritoine (n=1), déplacements accidentels de la sonde (n=4). Aucun décès n’a été rapporté à la GPE. Le recul total après GPE est de 15±11 mois alors que la durée moyenne de la première sonde a été de 8±6 mois. La sonde a dû être retirée 7 fois en raison de la dégradation du matériel et a été remplacée par un bouton de gastrostomie (n=7) ou par une sonde de Petzer (n=13). L’évolution nutritionnelle a été satisfaisante avec un rapport poids/taille significativement différent avant et après la GPE (87±14 % vs 97±14 %; p < 0,05). L’antibiothérapie prophylactique semble réduire l’incidence des infections cutanées. Le reflux gastro-œsophagien n’est pas aggravé par la GPE. La GPE est une technique fiable, peu coûteuse, avec une faible morbidité et un bénéfice nutritionnel certain.

Summary

Twenty-eight children underwent percutaneous endoscopic gastrostomy (PEG) with the «pull» technique, over a 3-year period at Lille Hospital. They were 7±5 years old and weighed 18±10 kg. Eighteen children suffered from neurological disorders (62 %) and 6, from cystic fibrosis (21 %). Technical problems occurred in 11 children: several gastric punctures (n=8), and cutting away the tube flange (n=3), were required. Twenty complications occurred in 12 children: cutaneous infections (n=7); pneumonia (n=6); ileus (n=2); pneumoperitoneum (n=1) and tube displacements (n=4). The mean lapse of time since PEG is 15±11 months, while the mean lifetime of the first tube was 8±6 months. The tube had to be removed on 7 occasions because of damage. It was replaced by a gastrostomic button (n=7) or by a Pezzer tube (n=13). The nutritional evolution was satisfactory as indicated by the weight/height ratio before and after PEG (87±14 % vs 97±14 %); (p < 0.05). Prophylactic antibiotherapy seems to reduce the incidence of cutaneous infections. Gastro-esophageal reflux was not aggravated by the operation. PEG is a reliable and cheap technique with low morbidity and nutritional advantages.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Références

  1. BEREZIN S., SCHWARZ S.M., HALATA M.S., NEWMAN L.J. — Gastroesophageal reflux secondary to gastrostomy tube placement.Am. J. Dis. Child., 1986,140, 699–701.

    PubMed  CAS  Google Scholar 

  2. BLACK T.L., FERNANDES E.T., ELLIS D.G.et al. — The effect of tube gastrostomy on gastroesophageal reflux in patients with esophageal atresia.J. Pediatr. Surg., 1991,26, 168–170.

    Article  PubMed  CAS  Google Scholar 

  3. CALTON W.C., MARTINDALE R.G., GOODEN S.M. — Complications of percutaneous endoscopic gastrostomy.Mil. Med., 1992,157, 358–360.

    PubMed  CAS  Google Scholar 

  4. CAPPELL M.S. — Esophageal bleeding after percutaneous endoscopic gastrostomy.J. Clin. Gastroenterol., 1988,10, 383–385.

    PubMed  CAS  Google Scholar 

  5. CHAMBRE J.F., DENIS B., CHAMPIGNEULLE B.et al. — Aphagie après ablation d’une gastrostomie endoscopique percutanée.Gastroenterol. Clin. Biol., 1991,15, 987–988.

    PubMed  CAS  Google Scholar 

  6. CORY D.A., FITZGERALD J.F., COHEN M.D. — Percutaneous nonendoscopic gastrostomy in children.Am. J. Roentgenol., 1988,151, 995–997.

    CAS  Google Scholar 

  7. DAVIS J.B., BOWDEN T.A., RIVES D.A. — Percutaneous endoscopic gastrostomy. Do surgeons and gastroenterologists get the same results?Am. Surg., 1990,56, 47–51.

    PubMed  Google Scholar 

  8. DEITEL M., BENDAGO M., SPRATT E.H., BURUL C.J., TO T.B. — Percutaneous endoscopic gastrostomy by the «pull» and introducer methods.Can. J. Surg., 1988,31, 102–104.

    PubMed  CAS  Google Scholar 

  9. DILORENZO J., DALTON B., MISKOVITZ P. — Percutaneous endoscopic gastrostomy. What are the benefits, what are the risks?Postgrad. Med., 1992,91, 277–281.

    PubMed  CAS  Google Scholar 

  10. FARCA A., MUNDO F., RODRIGUEZ G., GRIFE A., RAMIREZ VALERA A. — Endoscopic gastrostomy: a follow-up study.Rev. Gastroenterol. Mex., 1990,55, 203–206.

    PubMed  CAS  Google Scholar 

  11. GAUDERER M.W.L. — Percutaneous endoscopic gastrostomy: a 10-year experience with 220 children.J. Pediatr. Surg., 1991,26, 288–294.

    Article  PubMed  CAS  Google Scholar 

  12. GAUDERER M.W.L., OLSEN M.M., STELLATO T.A., DOKLER M.L. — Feeding gastrostomy button: experience and recommandations.J. Pediatr. Surg., 1988,23, 24–28.

    Article  PubMed  CAS  Google Scholar 

  13. GAUDERER M.W.L., PONSKY J.L., IZANT R.J. — Gastrostomy without laparotomy: a percutaneous endoscopic technique.J. Pediatr. Surg., 1980,15, 872–875.

    Article  PubMed  CAS  Google Scholar 

  14. GAUDERER M.W.L., STELLATO T.A., OLSEN M.M., DOKLER M.L. — Percutaneous endoscopic gastrostomy in 156 children: indications, technique and complications.Z. Kinderchir., 1988,43, 38–40.

    PubMed  Google Scholar 

  15. GAY F., EL NAWAR A., VAN GOSSUM A.et al. — Percutaneous endoscopic gastrostomy.Acta Gastroenterol. Belg., 1992,55, 285–294.

    PubMed  CAS  Google Scholar 

  16. GRANT J.P. — Comparison of percutaneous endoscopic gastrostomy with Stamm gastrostomy.Ann. Surg., 1988,207, 598–603.

    Article  PubMed  CAS  Google Scholar 

  17. GRANT J.P. — Percutaneous endoscopic gastrostomy: initial placement by single endoscopic technique and long-term follow-up.Ann. Surg., 1993,217, 168–174.

    Article  PubMed  CAS  Google Scholar 

  18. GRUNOW J.E., AL-HAFIDH A.S., TUNELL W.P. — Gastroesophageal reflux following percutaneous endoscopic gastrostomy in children.J. Pediatr. Surg., 1989,24, 42–45.

    Article  PubMed  CAS  Google Scholar 

  19. HALKIER B.K., HO C.S., YEE A.C. — Percutaneous feeding gastrostomy with the Seldinger technique: review of 252 patients.Radiology, 1989,171, 359–362.

    PubMed  CAS  Google Scholar 

  20. HO C.S., YEUNG E.Y. — Percutaneous gastrostomy and transgastric jejunostomy.Am. J. Roentgenol., 1992,158, 251–257.

    CAS  Google Scholar 

  21. HOLLANDS M.J., FLETCHER J.P., YOUNG J. — Percutaneous feeding gastrostomy.Med. J. Aust., 1989,151, 330–331.

    Google Scholar 

  22. HONNETH J., NEHEN H.G. — Percutaneous endoscopic gastrostomy.Dtsch. Med. Wochenschr., 1991,116, 1532–1533.

    PubMed  CAS  Google Scholar 

  23. HULL M.A., RAWLINGS J., MURRAY F.E.et al. — Audit of outcome of long term enteral nutrition by percutaneous endoscopic gastrostomy.Lancet, 1993,341, 869–872.

    Article  PubMed  CAS  Google Scholar 

  24. JAIN N.K., LARSON D.E., SCHROEDER K.W., BURTON D.D., CANON K.P., DIMAGNO E.P. — Antibiotic prophylaxis for percutaneous endoscopic gastrostomy: A prospective randomized, double blind clinical trial.Ann. Intern. Med., 1987,107, 824–828.

    PubMed  CAS  Google Scholar 

  25. JARNAGIN W.R., DUH Q.Y., MULVIHILL S.J., RIDGE J.A., SCHROCK T.R., WAY L.W. — The efficacy and limitations of percutaneous endoscopic gastrostomy.Arch. Surg., 1992,127, 261–264.

    PubMed  CAS  Google Scholar 

  26. JOHNSON D.A., HACKER J.F., BENJAMIN S.B.et al. — Percutaneous endoscopic gastrostomy effects on gastroesophageal reflux and the lower esophageal sphincter.Am. J. Gastroenterol., 1987,82, 622–624.

    PubMed  CAS  Google Scholar 

  27. JOLLEY S.G., IDE SMITH E., TUNELL W.P. — Protective antireflux operation with feeding gastrostomy. Experience with children.Ann. Surg., 1985,201, 736–739.

    Article  PubMed  CAS  Google Scholar 

  28. JOLLEY S.G., TUNELL W.P., HOELZER D.J., THOMAS S., IDE SMITH E. — Lower esophageal pressure changes with tube gastrostomy: a causative factor of gastroesophageal reflux in children?J. Pediatr. Surg., 1986,21, 624–627.

    Article  PubMed  CAS  Google Scholar 

  29. KADOTA T., NAKAGAWA K., TAGUCHI J.et al. — A simplified percutaneous endoscopic gastrostomy using the trocard introducer technique with peel-away sheath.Surg. Gynecol. Obstet., 1991,173, 490–494.

    PubMed  CAS  Google Scholar 

  30. KIRBY D.F., CRAIG R.M., TSANG T., PLOTNICK B.H. — Percutaneous endoscopic gastrostomies: a prospective evaluation and review of the literature.JPEN, 1986,10, 155–159.

    CAS  Google Scholar 

  31. KOZAREK R.A., BALL T.J., RYAN J.A. — When push comes to shove: a comparison between two methods of percutaneous endoscopic gastrostomy.Am. J. Gastroenterol., 1986,81, 642–646.

    PubMed  CAS  Google Scholar 

  32. LANGER J.C., WESSON D.E., EIN S.H.et al. — Feeding gastrostomy in neurologically impaired children: is an antireflux procedure necessary?J. Pediatr. Gastroenterol. Nutr., 1988,7, 837–841.

    PubMed  CAS  Google Scholar 

  33. LARSON D.E., BURTON D.D., SCHROEDER K.W., DIMAGNO E.P. — Percutaneous endoscopic gastrostomy. Indications, success, complications, and mortality in 314 consecutive patients.Gastroenterology, 1987,93, 48–52.

    PubMed  CAS  Google Scholar 

  34. MAC FAYDEN B.V., CATALANO M.F., RAIJMAN I., GHOBRIAL R. — Percutaneous endoscopic gastrostomy with jejunal extension: a new technique.Am. J. Gastroenterol., 1992,87, 725–728.

    Google Scholar 

  35. MILLER R.E., CASTLEMAIN B., LACQUA F.J., KOTLER D.P. — Percutaneous endoscopic gastrostomy. Results in 316 patients and review of literature.Surg. Endosc., 1989,3, 186–190.

    Article  PubMed  CAS  Google Scholar 

  36. MORAN B.J., FROST R.A. — Percutaneous endoscopic gastrostomy in 41 patients: indications and clinical outcome.J. R. Soc. Med., 1992,85, 320–321.

    PubMed  CAS  Google Scholar 

  37. MORAN B.J., TAYLOR M.B., JOHNSON C.D. — Percutaneous endoscopic gastrostomy.Br. J. Surg., 1990,77, 858–862.

    Article  PubMed  CAS  Google Scholar 

  38. MOUGENOT J.F., CHAPOY P., JAN D.et al. — Gastrostomie endoscopique percutanée chez l’enfant. A propos de 21 cas. Groupe Francophone de Gastroentérologie et Nutrition Pédiatriques, Tunis, 20–22 septembre 1991.Arch. Fr. Pédiatr., 1992,49, 570 (résumé).

    Google Scholar 

  39. MOUGENOT J.F., LIGUORY C., CHAPOY P. — Endoscopie digestive interventionnelle.Arch. Fr. Pédiatr., 1991,48, 571–579.

    PubMed  CAS  Google Scholar 

  40. PATEL P.H., HUNTER W., WILLIS M., THOMAS E. — Upper gastrointestinal hemorrhage secondary to gastric ulcer complicating percutaneous endoscopic gastrostomy.Gastrointest. Endosc., 1988,34, 288–289.

    PubMed  CAS  Google Scholar 

  41. PONSKY J.L., GAUDERER M.W.L. — Percutaneous endoscopic gastrostomy: indications, limitations, techniques, and results.World J. Surg., 1989,13, 165–170.

    Article  PubMed  CAS  Google Scholar 

  42. PONSKY J.L., GAUDERER M.W.L., STELLATO T.A. — Percutaneous endoscopic gastrostomy. Review of 150 cases.Arch. Surg., 1983,118, 913–914.

    PubMed  CAS  Google Scholar 

  43. REMPEL G.R., COLWELL S.O., NELSON R.P. — Growth in children with cerebral palsy fed via gastrostomy.Pediatrics, 1988,82, 857–862.

    PubMed  CAS  Google Scholar 

  44. RUSSELL T.R., BROTMAN M., NORRIS F. — Percutaneous gastrostomy. A new simplified and cost-effective technique.Am. J. Surg., 1984,148, 132–137.

    Article  PubMed  CAS  Google Scholar 

  45. SAINI S., MUELLER P.R., GAA J.et al. — Percutaneous gastrostomy with gastropexy: experience in 125 patients.Am. J. Roentgenol., 1990,154, 1003–1006.

    CAS  Google Scholar 

  46. SANGSTER W., CUDDINGTON G.D., BACHULIS B.L. — Percutaneous endoscopic gastrostomy.Am. J. Surg., 1988, 155, 677–679.

    Article  PubMed  CAS  Google Scholar 

  47. SCOTT J.S., DE LA TORRE R.A., UNGER S.W. — Comparison of operative versus percutaneous endoscopic gastrostomy tube placement in the elderly.Am. Surg., 1991,57, 338–340.

    PubMed  CAS  Google Scholar 

  48. SEEKRI I.K., RESCORLA F.J., CANAL D.F., ZOLLINGER T.W., SAYWELL R., GROSFELD J.L. — Lesser curvature gastrostomy reduces the incidence of postoperative gastroesophageal reflux.J. Pediatr. Surg., 1991,26, 982–984.

    PubMed  CAS  Google Scholar 

  49. SEMPE M., PEDRON G., ROY-PERNOT M.P. — Augmentation globale ou la valeur relative du poids. In Auxologie: méthode et séquences.Théraplix, 1979, 37–50.

  50. SEYRIG J.A., GORDIN J., COSTA B.et al. — Gastrostomie percutanée endoscopique. Cent soixante-quatorze observations.Presse Méd., 1990,19, 1035–1039.

    PubMed  CAS  Google Scholar 

  51. STELLATO T.A., GAUDERER M.W.L., PONSKY J.L. — Percutaneous endoscopic gastrostomy following previous abdominal surgery.Ann. Surg., 1984,200, 46–50.

    Article  PubMed  CAS  Google Scholar 

  52. STERN J.S. — Comparison of percutaneous endoscopic gastrostomy with surgical gastrostomy at a community hospital.Am. J. Gastroenterol., 1986,81, 1171–1173.

    PubMed  CAS  Google Scholar 

  53. STIEGMANN G., GOFF J.S., SILAS D., PEARLMAN N., SUN J., NORTON L. — Operative versus endoscopic gastrostomy: final results of a prospective randomized trial.Gastrointest. Endosc., 1990,36, 1–5.

    Article  PubMed  CAS  Google Scholar 

  54. STRINGEL G. — Gastrostomy with antireflux properties.J. Pediatr. Surg., 1990,25, 1019–1021.

    Article  PubMed  CAS  Google Scholar 

  55. SULLIVAN P.B. — Gastrostomy and the disabled child.Dev. Med. Child. Neurol., 1992,34, 552–555.

    Article  PubMed  CAS  Google Scholar 

  56. TOWNSEND M.C., FLANCBAUM L., CLOUTIER C.T., ARNOLD M.W. — Early postlaparotomy percutaneous endoscopic gastrostomy.Surg. Gynecol. Obstet., 1992,174, 46–48.

    PubMed  CAS  Google Scholar 

  57. WHEATLEY M.J., WESLEY J.R., TKACH D.M., CORAN A.G. — Long-term follow-up of brain-damaged children requiring feeding gastrostomy: should an antireflux procedure always be performed?J. Pediatr. Surg., 1991,26, 301–305.

    Article  PubMed  CAS  Google Scholar 

  58. WICKS C., GIMSON A., VLAVIANOS P.et al. — Assessment of the percutaneous endoscopic gastrostomy feeding tube as part of an integrated approach to enteral feeding.Gut, 1992,33, 613–616.

    Article  PubMed  CAS  Google Scholar 

  59. WOJTOWYCZ M.M.M., ARATA J.A. — Subcutaneous emphysema after percutaneous gastrostomy.Am. J. Roentgenol., 1988,151, 1311–1312.

    Google Scholar 

Download references

Author information

Author notes

  1. V. Launay

    Present address: Service de Pédiatrie, Gastroentérologie Pédiatrique et Génétique Médicale, Hôpital Huriez, 1, place de Verdun, 59037, Lille Cedex, France

Authors and Affiliations

  1. Service de Pédiatrie, Gastroentérologie Pédiatrique et Génétique Médicale, Hôpital Huriez, 1, place de Verdun, 59037, Lille Cedex, France

    F. Gottrand & D. Turck

Authors
  1. V. Launay
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. F. Gottrand
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. D. Turck
    View author publications

    You can also search for this author in PubMed Google Scholar

About this article

Cite this article

Launay, V., Gottrand, F. & Turck, D. La gastrostomie percutanée endoscopique chez l’enfant. Acta Endosc 24, 351–361 (1994). https://doi.org/10.1007/BF02970060

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02970060

Mots-clés

Key-words

Search

Navigation