Laparoscopic-Assisted Percutaneous Endoscopic Gastrostomy Combined with CT-GC

• Published in: Journal of investigative surgery Vol. 30; no. 3; pp. 193 - 200
• Main Authors: Kato, Kazuya, Iwasaki, Yoshiaki, Onodera, Kazuhiko, Matsuda, Minoru, Higuchi, Mineko, Kato, Kimitaka, Kato, Yurina, Taniguchi, Masahiko, Furukawa, Hiroyuki
• Format: Journal Article
• Language: English
• Published: United States Taylor & Francis 04.05.2017; Taylor & Francis Group
• Subjects: Aged, 80 and over; Colonography, Computed Tomographic - methods; CT-gastrocolonography (CT-GC); Female; gastrocolic fistula; Gastroscopy; Gastrostomy - methods; Humans; iatrogenic colic perforation; laparoscopic surgery; laparoscopic-assisted PEG (LAPEG); Laparoscopy; Male; Multidetector Computed Tomography; percutaneous endoscopic gastrostomy (PEG); Prospective Studies; gastrocolic fistula; percutaneous endoscopic gastrostomy (PEG); CT-gastrocolonography (CT-GC); iatrogenic colic perforation; laparoscopic surgery; laparoscopic-assisted PEG (LAPEG)
• ISSN: 0894-1939; 1521-0553
• DOI: 10.1080/08941939.2016.1232451

Purpose: Despite the widespread use of percutaneous endoscopic gastrostomy (PEG) tubes, their placement may be associated with a variety of complications, including gastrocolic fistula. Materials and Methods: In total, seven high-risk individuals diagnosed using computed tomography (CT)-gastrocolonography (GC) underwent laparoscopic-assisted PEG (LAPEG) placement. Study endpoints included the success of LAPEG under local anesthetic and intravenous sedation, inability to thread the PEG tube, the eventual tube location, the number of tube adjustments needed, adverse events, the operating time, and PEG tube-related infection. Results: In total, 135 PEG procedures were performed during this study. Successful CT-GC was achieved in all 135 patients, and we successfully used a standard PEG technique to place the gastrostomy tube in 128 patients (95%). In seven patients (5%), the LAPEG technique was used because the transverse colon became interposed between the abdominal wall and the anterior wall of the stomach. LAPEG procedure-related minor complications were observed in two patients. Conclusions: LAPEG combined with CT-GC can be used for patients with difficult anatomical orientations and may minimize the risk of complications in PEG placement.