Early experience with endoscopic percutaneous gastrostomy
W. E. Strodel, J. Lemmer, F. Eckhauser, M. Botham and T. Dent
We performed endoscopic percutaneous gastrostomy (EPG) on 22 patients. All
procedures were performed using local anesthesia with intravenous diazepam
sedation. Formal laparotomy was not required. The mean patient age was 58
years (range, 21 to 83 years). Indications for EPG placement included
neurologic disorders in 17 patients, head and neck tumors in four patients,
and esophageal disease in one patient. The mean operative time for EPG was
27.5 minutes, with a range of 11 to 60 minutes. Two major complications, a
gastrocolic fistula and an intraperitoneal gastric leak, occurred early in
the series. The technique has been modified with no similar complications.
Pneumoperitoneum after EPG was demonstrated in eight patients without
sequelae. Ileus following EPG was not observed in any patient, and enteral
feedings were uniformly resumed 48 hours after tube placement. Our early
experience with EPG suggests that this technique is a safe, cost-effective,
and time-saving alternative to traditional gastrostomy tube placement.
