Selection of Methods for Percutaneous Endoscopic Gastrostomy (PEG) that is more Safety and Useful Techniques on the Patients

Author(s): Ken Kawaura, Tohru Itoh, Kazu Hamada, Hidekazu Kitakata, Sadahumi Azukisawa, Hideyuki Okamura, Sachio Urashima, Masaru Sakurai, Masao Ishizaki

Objective: Percutaneous endoscopic gastrostomy has been widely adopted, and its use is increasing in Japan due to the rapid aging of society and promotion of medical care at home. Percutaneous endoscopic gastrostomy is performed in patients with a variety of underlying basic diseases. Therefore, a procedure that is safe and less burdensome for the patient is required.

Material and methods: We studied a percutaneous endoscopic gastrostomy procedure that is both safe and less burdensome, in 260 patients undergoing gastrostomy in our department. The items studied were postoperative risk factors for fever, postoperative risk factors for elevated leukocyte count, and risk factors for C-reactive protein (CRP) elevation.

Results: Serious complications were fewer with the three-point fixing method of the abdominal and gastric walls. Multivariate analysis indicated that the conventional Pull method was an independent risk factor for fever (P<0.0001), and the bedridden state of the patient was a risk factor for leukocyte elevation. High Prognostic Nutrition Index (PNI) was an independent risk factor for CRP elevation.

Conclusions: Percutaneous endoscopic gastrostomy performed with the Modified Introducer method by fixing the abdominal and gastric walls showed fewer complications and reduced burden on the patient compared to other methods.