J Korean Med Sci.  2013 Dec;28(12):1781-1787. 10.3346/jkms.2013.28.12.1781.

Comparison of Complications between Endoscopic and Percutaneous Replacement of Percutaneous Endoscopic Gastrostomy Tubes

• Lee CG
• Kang HW
• Lim YJ
• Lee JK
• Koh MS
• Lee JH
• Yang CH
• Kim JH

• KMID: 1779420
• DOI: http://doi.org/10.3346/jkms.2013.28.12.1781

Abstract

When replacing percutaneous endoscopic gastrostomy (PEG) tubes, an internal bolster may be retrieved either percutaneously or endoscopically. The aim of this study was to compare the complications of percutaneous and endoscopic method during PEG tube replacement. The medical records of 330 patients who received PEG tube replacement were retrospectively analyzed. According to the removal method of internal bolster, we categorized as endoscopic group and percutaneous group. Demographic data, procedure-related complications and risk factors were investigated. There were 176 cases (53.3%) in endoscopic group and 154 cases (46.7%) in percutaneous group. The overall immediate complication rate during PEG tube replacement was 4.8%. Bleeding from the stoma (1.3%) occurred in percutaneous group, whereas esophageal mucosal laceration (7.4%) and microperforation (0.6%) occurred in endoscopic group. The immediate complication rate was significantly lower in the percutaneous method (OR, 6.57; 95% CI, 1.47-29.38, P=0.014). In multivariate analysis, old age was a significant risk factor of esophageal laceration and microperforation during PEG tube replacement (OR, 3.83; 95% CI, 1.04-14.07, P=0.043). The percutaneous method may be more safe and feasible for replacing PEG tubes than the endoscopic method in old patients.

Keyword

Gastrostomy; Methods; Complications

MeSH Terms

Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Demography
Esophageal Perforation/etiology
Female
Gastroscopy
Gastrostomy/adverse effects/*methods
Hemorrhage/etiology
Humans
Male
Middle Aged
Multivariate Analysis
Odds Ratio
*Postoperative Complications
Retrospective Studies
Risk Factors
Young Adult

Figure

• 

  Fig. 1 Photographs of removal. (A) Percutaneous method: PEG tube can be removed by pulling the PEG tube out of the abdominal wall. (B) Endoscopic method: Remnant tube adjacent to the bumper was captured the snare under endoscopic guide, then, it was retrieved out of the mouth.

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