Percutaneous Endoscopic Gastrostomy in ICU Patients with Previous Laparotomy

Guzzo, James L.; Bochicchio, Grant V.; Haan, James; Bochicchio, Kelly; Kole, Kerry; Scalea, Thomas M.
May 2005
American Surgeon;May2005, Vol. 71 Issue 5, p420
Academic Journal
To our knowledge, there is an absence of data evaluating the safety and efficacy of percutaneous endoscopic gastrostomy (PEG) placement in ICU patients with previous abdominal surgery. Our goals were to determine the complication rate of PEG in ICU patients who either had a recent or prior laparotomy compared to patients without any prior abdominal surgery. Prospective data was collected on 42 consecutive patients with prior abdominal surgery who underwent PEG placement in a university ICU setting during a 3-year period. These patients were further stratified by time of previous abdominal surgery: recent = abdominal surgery during the current hospitalization; old = abdominal surgery done prior to the current hospitalization and >30 days. Complications were defined as technical problems, local infection, tube dislodgment, and bleeding. This data was compared to results of 75 consecutive PEG placements in ICU patients with no previous abdominal surgery (NPAS) at the same institution. A total of 117 patients were included in the study. Sixty-two (58%) of the patients were trauma patients and 45 (42%) had other pathology. The mean age of the study population was 53 ± 15 years and they were primarily male (75%). The overall complication rates were as follows: local wound = 18.7 per cent, technical problems = 4 per cent, PEG dislodgment = 7.4 per cent, and bleeding = 3 per cent. Of the 42 patients with prior abdominal surgery, 22 were recent, and 20 were old. Local wound complications were the most common complication when stratified by PEG category (virgin = 17.3%, recent = 18%, and old = 15%) followed by dislodgment (virgin = 6.7%, recent = 9%, and old = 5%). There were no significant differences in complication rates when comparing specific complications by PEG category as analyzed by x² analysis. PEG should be considered in all patients with previous laparotomy in need for long-term enteral access.


Related Articles

  • Intestine.  // Current Medical Literature: Gastroenterology;2004, Vol. 23 Issue 3, p59 

    Comments on the article "Percutaneous gastrostomy in patients with a ventriculoperitoneal shunt: case series and review," by R. Baird and colleagues, published in the 2004 issue of the periodical "Gastrointestinal Endoscopy". Retrospective analysis of cases of patients with ventriculoperitoneal...

  • Percutaneous Endoscopic Gastrostomy Effects on Gastroesophageal Reflux and the Lower Esophageal Sphincter. Johnson, David A.; Hacker III, Joseph F.; Benjamin, Stanley B.; Ciarleglio, Cecelia A.; Chobanian, Sarkis J.; Van Ness, Michael M.; Cattau Jr., Edward L. // American Journal of Gastroenterology;Jul1987, Vol. 82 Issue 7, p622 

    Focuses on the effects of percutaneous endoscopic gastrostomy (PEG) on gastroesophageal reflux and the lower esophageal sphincter. Purpose of feeding gastrostomy; Details on the pre-PEG evaluation of patients; Procedure of the gastrostomy placement.

  • Safer Percutaneous Gastrostomy Placement in Patients with Carcinomatosis. Marshall Jr., Harry P.; Garcia, Alvaro; Holt, Richard W. // American Surgeon;Aug2004, Vol. 70 Issue 8, p740 

    Discusses the percutaneous gastrostomy (PEG) placement in patients with carcinomatosis. Risks associated with PEG procedure; Procedures included in PEG; Outcome of PEG placement.

  • Current microbiology of percutaneous endoscopic gastrostomy tube (PEG tube) insertion site infections in patients with cancer. Rolston, Kenneth; Mihu, Coralia; Tarrand, Jeffrey // Supportive Care in Cancer;Aug2011, Vol. 19 Issue 8, p1267 

    Purpose: Percutaneous endoscopic gastrostomy (PEG) is frequently used to provide enteral access in cancer patients who are unable to swallow. Infection is an important complication in this setting. Current microbiological data are needed to guide infection prevention and treatment strategies....

  • Pneumoperitoneum after percutaneous endoscopic gastrostomy in patients in the intensive care unit. Alley, Joshua B.; Corneille, Michael G.; Stewart, Ronald M.; Dent, Daniel L. // American Surgeon;Aug2007, Vol. 73 Issue 8, p765 

    Percutaneous endoscopic gastrostomy (PEG) has been associated with up to a 55 per cent incidence of pneumoperitoneum in the literature. A review was conducted of 120 consecutive PEG tube insertions in patients in the intensive care unit (ICU) to determine the incidence and significance of...

  • Percutaneous Endoscopic Gastrostomy in Patients with an Open Abdomen. Block, Ernest F.J.; Cheatham, Michael L.; Bee, Tiffany K. // American Surgeon;Sep2001, Vol. 67 Issue 9, p913 

    Percutaneous endoscopic gastrostomy is a commonly performed procedure for enteral access. In the past decade surgeons have used the open abdomen technique with increased frequency for the treatment of intra-abdominal compartment syndrome. Because these patients often have associated malnutrition...

  • A randomized prospective trial of immediate vs. next-day feeding after percutaneous endoscopic gastrostomy in intensive care patients. Stein, Jurgen; Schulte-Bockholt, Arnd; Sabin, Marion; Keymling, Michael // Intensive Care Medicine;Nov2002, Vol. 28 Issue 11, p1656 

    Objective. To determine the effect of immediate vs. next-day feeding after percutaneous endoscopic gastrostomy in intensive care and intermediate care patients. Design and setting. A prospective, randomized, controlled trial of the clinical outcome in two German hospitals. Patients. The study...

  • Percutaneous Endoscopic Gastrostomy and Stomal Bilious Leakage in a Patient With a Billroth II Gastrectomy. Batoon, Sherwin B.; Vela, Anthony T.; Dave, Devang; Wahid, Zahid; Arunacahalam, Mathu; Shatenfeld, Gregoriy; Pavlovici, Sherban // American Journal of Gastroenterology;Nov2000, Vol. 95 Issue 11, p3320 

    Describes a case of percutaneous endoscopic gastrostomy (PEG) and stomal bilious leakage in an elderly woman with a Billroth II gastrectomy. Symptoms presented by the patient; Indications of PEG tube placement; Efficacy of scintigraphic method in detecting gastroesophageal reflux in patients...

  • Gastrostomía endoscópica percutánea asistida por laparoscopia: Reporte de caso. Pinilla Morales, Raúl Eduardo; Hernández Restrepo, Juan David // Revista Colombiana de Gastroenterología;Apr2011, Vol. 26 Issue 2, p147 

    Percutaneous endoscopic gastrostomy (PEG) is the choice technique to establish a feeding route for patients that requiring special nutritional support for more than 4 weeks; however, to be an intervention performed percutaneously, the inability to demonstrate transillumination of the abdominal...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics