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Gastrostomy insertion in the 21st century: PEG or laparoscopic? Report from a large single-centre series

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Abstract

Purpose

To determine whether laparoscopic-assisted gastrostomy (LAG) has superseded percutaneous endoscopic gastrostomy (PEG) based on the clinical outcomes.

Methods

A retrospective study was undertaken for the period January 06–December 09. Demographic and clinical outcomes were recorded and the two groups were compared.

Results

164 patients were studied (PEG, n = 107; LAG, n = 57). 93.5 % of PEG patients required two general anaesthetics compared with 8 % of LAG patients. Median time to using the gastrostomy was 24 (range 0–168) h in PEG and 0 (0–96) h in LAG patients (p < 0.001). Major complications occurred in 15/107 (14 %) of PEG and 2/57 (3.5 %) of LAG patients (p = 0.05). Re-operation rate following complications was 18/107 (16.8 %) for PEG and 3/57 (5.2 %) for LAG (p = 0.05). Minor complications arose in 41/107 (38 %) of PEG and 32/57 (56 %) of LAG (p = 0.05). Post-operative hospital stay was 2 (1–40) days for PEG and 2 (0–20) days for LAG (p = 0.01). The day-case rate was 0/107 for PEG and 5/57 (9 %) for LAG. There was no gastrostomy-related mortality in the series.

Conclusion

LAG requires fewer anaesthetics, is associated with shorter time to feeding, shortened hospital stay and has a reduced risk of major complications. LAG is a very good alternative to the PEG in children.

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Authors and Affiliations

  1. Birmingham Children’s Hospital, Birmingham, UK

    Ruth Clare Wragg, Heidi Salminen, Max Pachl, Michael Singh, Anthony Lander, Ingo Jester, Dakshesh Parikh & Girish Jawaheer

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  1. Ruth Clare Wragg
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  2. Heidi Salminen
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  3. Max Pachl
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  4. Michael Singh
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  5. Anthony Lander
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  6. Ingo Jester
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  7. Dakshesh Parikh
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  8. Girish Jawaheer
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Correspondence to Ruth Clare Wragg.

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Wragg, R.C., Salminen, H., Pachl, M. et al. Gastrostomy insertion in the 21st century: PEG or laparoscopic? Report from a large single-centre series. Pediatr Surg Int 28, 443–448 (2012). https://doi.org/10.1007/s00383-012-3079-5

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  • DOI: https://doi.org/10.1007/s00383-012-3079-5

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