Abstract
Background
Percutaneous endoscopic gastrostomy (PEG) has been established as a minimally invasive and safe procedure to provide nutritional support in patients unable to swallow food properly. However, a relative contraindication for the procedure is the existence of previous abdominal surgery.
Method
We described our experience in performing PEG on 37 patients who had undergone surgery for upper abdominal diseases 10 days to 25 years previously. This group of 37 patients, 22 of whom had been subjected to laparotomy in the previous 2 weeks, was compared with 291 patients who had an intact abdomen regarding failure of the procedure to be performed, major and minor complications, and mortality.
Results
The two groups were found to be comparable: failure rates of 2.71% (1/37) and 1.72% (5/291), no major complications, no mortality, minor complication rates of 2.77% (1/36) and 2.44% (7/286).
Conclusions
The PEG procedure is associated with minimal risk even in patients previously subjected to upper abdominal surgery, as long as transillumination of the stomach and finger palpation are seen clearly during endoscopy.
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References
Amann W, Mischinger HJ, Berger A, Rosanelli G, Schweiger W, Werkgartner G, Fruhwirth J, Hauser H (1997) Percutaneous endoscopic gastrostomy (PEG). Surg Endosc 11: 741–744 DOI: 10.1007/s004649900440
Atabek U, Mayer D, Amin A, Camishion RC (1993) Pancreatic cystogastrostomy by combined upper endoscopy and percutaneous transgastric instrumentation. J Laparoendosc Surg 3: 501–504
Cannizzaro R, Bortoluzzi F, Valentini M, Scarabelli C, Campagnutta E, Sozzi M, Fornasarig M, Poletti M (1995) Percutaneous endoscopic gastrostomy as a decompressive technique in bowel obstruction due to abdominal carcinomatosis. Endoscopy 27: 317–320
Dye KR, Pattison CP, Dye NV (1986) Percutaneous endoscopic gastrostomy: technical modifications for improved results. South Med J 79: 24–27
Eckhauser ML, Ferron JP (1985) The use of dual percutaneous endoscopic gastrostomy in the management of chronic intermittent gastric volvulus. Gastrointest Endosc 31: 340–342
Foutch PG, Talbert GA, Waring JP, Sanowski RA (1988) Percutaneous endoscopic gastrostomy in patients with prior abdominal surgery: virtues of the safe tract. Am J Gastroenterol 83: 147–150
Grant JP (1993) Percutaneous endoscopic gastrostomy: initial placement by single endoscopic technique and long-term follow-up. Ann Surg 217: 168–174
Ho HS, Ngo H (1999) Gastrostomy for enteral access: a comparison among placement by laparotomy, laparoscopy, and endoscopy. Surg Endosc 13: 991–994 DOI: 10.1007/s004649901153
Kurchin A, Halloran W, Kornfield R (1988) Assessing the feasibility of percutaneous endoscopic gastrostomy following gastrectomy. Gastrointest Endosc 34: 366
Lin XZ, Yang SH, Chen CY, Tsai HM (1999) Percutaneous endoscopic gastrostomy in a patient with subtotal gastrectomy. Hepatogastroenterology 46: 180–181
Mellinger JD, Ponsky JL (1998) Percutaneous endoscopic gastrostomy: state of the art, 1998. Endoscopy 30: 126–132
Miller RE, Castlemain B, Lacqua FJ, Kotler DP (1989) Percutaneous endoscopic gastrostomy: results in 316 patients and review of literature. Surg Endosc 3: 186–190
Ponsky JL (1998) Transilluminating percutaneous endoscopic gastrostomy. Endoscopy 30: 656
Ponsky JL, Aszodi A (1982) External biliary-gastric fistula: a simple method for recycling bile. Am J Gastroenterol 77: 939–940
Safadi BY, Marks JM, Ponsky JL (1998) Percutaneous endoscopic gastrostomy: an update. Endoscopy 30: 781–789
Stellato TA (1992) Expanded applications of percutaneous endoscopic gastrostomy. Gastrointest Endosc Clin North Am 2: 249–257
Stellato TA, Gauderer MWL, Ponsky JL (1984) Percutaneous endoscopic gastrostomy following previous abdominal surgery. Ann Surg 200: 46–50
Stewart JAD, Hagan P (1998) Failure to transilluminate the stomach is not an absolute contraindication to PEG insertion. Endoscopy 30: 621–622
Szanto I, Voros A, Nagy K, Kiss J, Vimlati L, Bohak A (1998) Percutaneous endoscopic gastrostomy/jejunostomy in the early postoperative period. Endoscopy 30: S1
Townsend MC, Flancbaum L, Cloutier CT, Arnold MW (1992) Early postlaparotomy percutaneous endoscopic gastrostomy. Surg Gynecol Obstet 174: 46–48
Yamazaki T, Sakai Y, Hatakeyama K, Hoshiyama Y (1999) Colocutaneous fistula after percutaneous endoscopic gastrostomy in a remnant stomach. Surg Endosc 13: 280–282 DOI: 10.1007/s004649900964
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Online publication: 5 October 2000
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Eleftheriadis, E., Kotzampassi, K. Percutaneous endoscopic gastrostomy after abdominal surgery. Surg Endosc 15, 213–216 (2001). https://doi.org/10.1007/s004640000250
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DOI: https://doi.org/10.1007/s004640000250