Retrospective survey of 426 cases of percutaneous endoscopic gastrostomy

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  • Nakatsuka Akihiko
    Department of Gastroenterology, Morioka Municipital Hospital, Morioka, Japan
  • Kamiya Ryoichi
    Department of Gastroenterology, Morioka Municipital Hospital, Morioka, Japan
  • Kitada Kenichi
    Department of Gastroenterology, Morioka Municipital Hospital, Morioka, Japan
  • Kumagai Ichiro
    Department of Gastroenterology, Morioka Municipital Hospital, Morioka, Japan
  • Kondo Koryo
    Department of Gastroenterology, Morioka Municipital Hospital, Morioka, Japan
  • Kato Akinobu
    Department of Gastroenterology, Morioka Municipital Hospital, Morioka, Japan
  • Akasaka Iichiro
    Department of Endoscopy, Iwate Prefectural Central Hospital, Morioka, Japan

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Other Title
  • 経皮内視鏡的胃瘻造設術を行った426例の遡及的検討
  • 経皮内視鏡的胃瘻造設術を行った426例の遡及的検討 : CT撮影法と大腸内視鏡補助の必要度関連を中心に
  • ケイヒ ナイシキョウテキ イロウゾウセツジュツ オ オコナッタ 426レイ ノ ソキュウテキ ケントウ : CT サツエイホウ ト ダイチョウ ナイシキョウ ホジョ ノ ヒツヨウド カンレン オ チュウシン ニ
  • The relation between CT scan findings and necessity of colonoscopy assistance
  • CT撮影法と大腸内視鏡補助の必要度関連を中心に

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Abstract

Percutaneous endoscopic gastrostomy (PEG) has become a common medical treatment, although interposition of the transverse colon or the mesentery is difficult. Colonoscopy assisted PEG (C-PEG) helps to resolve this problem. In this report, 426 PEG cases were divided into three groups according to their CT scan findings immediately prior to PEG; group A: no air injection into the stomach, B: air injected into the stomach through gastric tubes, C: air injected during esophagogastroduodenoscopy (EGD) in the left-lateral position. The numbers in groups A, B, and C were 137, 137, and 152, respectively. When CT scan revealed obstacles such as transverse colon or the mesentery in the ventral side of the stomach, C-PEG instead of ordinary PEG was adopted. The numbers of C-PEG cases in groups A, B, and C were 21 (15.3%), 11 (8.0%), and 6 (3.9%), respectively. These results indicate that air injection into the stomach during EGD in the left lateral position is feasible for resolution of the obstacles. Our C-PEG strategy demonstrated satisfactory outcomes with no mispuncturing of the colon or mesentery in any groups and successful completion in 97.4% of cases. CT scanning revealed that air injection into the stomach in the left-side down position is advisable to narrow down the subjects of C-PEG. C-PEG seemed safe treatment.

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