Percutaneous endoscopic gastrostomy: Experience at King Abdullah University Hospital, Jordan

Background: Percutaneous endoscopic gastrostomy (PEG)

tubes are widely used for nutritional support of patients with dysfunctional swallowing of various etiologies and an otherwise intact gastrointestinal tract. The short and longterm outcomes of enteral nutrition using this technique in Jordan are largely unknown.

Objective: We aimed to describe the indications, the rate of successful placement, complication rates, and long term outcome of PEG tubes placed in a variety of patients at King Abdullah University Hospital in Northern Jordan.

Methods: Between the period from April, 2003, until March, 2007, 155 consecutive patients with PEG tubes inserted during this period (using the Ponsky pull technique) were identified from our database. The demographic data, primary and secondary underlying medical conditions, and post-placement complications were analyzed. Phone calls with caregivers were made to gather information about the short and long-term outcomes of using PEG tubes.

Results: Complete data were available for 85/155 (55%) of the patients reviewed. PEG tubes were successfully placed in 99% of cases, with no procedure-related complications. The most common indication for PEG tube placement was neuromuscular dysphagia documented in 46%, followed by decrease in level of consciousness or coma in 38% of the patients. Post placement major complications were noted in 5% of cases in the form of sepsis, bleeding, and stoma mucosa necrosis. Minor complications such as stoma leak, skin irritation, and gastrointestinal upset were noted in 41% of patients. At four year follow up, the overall mortality was 53%. Twenty-one percent of patients had their tube replaced, 27% recovered normal swallowing function and had their tube removed, while 20% of patients were still dependent on the tube for nutritional support.

Conclusions: PEG tube placement at our institution has an acceptable success rate. Short and long-term outcomes are comparable to published series. Proper selection of patients with expected survival benefit would likely minimize the mortality and the complication rate.

Key-words:

Percutaneous endoscopic gastrostomy - Mortality rate - Complications.

Publication History

Received: 15 September 2009

Accepted: 26 October 2009

Article published online:
23 May 2022