Impact of upper endoscopic survey during percutaneous endoscopic gastrostomy tube placement

J. P. Regan, Brian J. Dunkin, E. S. Cho, J. L. Flowers

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Background: No consensus exists concerning the utility of a full diagnostic upper endoscopy during percutaneous endoscopic gastrostomy (PEG) tube placement. We evaluate the effect of a complete survey on identifying and treating unsuspected gastrointestinal pathology. Methods: During a 10-year period (1990-2000), 1,706 patients underwent attempted PEG tube placement by five different surgical endoscopists at one institution. A complete survey of the esophagus, stomach, and proximal duodenum was attempted in all cases. Endoscopic findings and recommendations were recorded in a computerized log and patient charts. Pathology results were obtained from a computerized pathology database and patient charts. Results: Placement of a PEG tube was successful in 97%, and a full survey was possible in 99% of the cases. Pathologic findings were found in 38% of the surveyed patients (esophagus, 7%; stomach, 24%; duodenum, 7%). One group with gastrointestinal polyps or gastric ulcers (5.7%) was identified as possible candidates for endoscopic intervention. In 30% of this group (1.8% of the total) a biopsy was performed, or bleeding was treated endoscopically. In a second group pathology was identified in the duodenum (6.4%) that would not have been recognized without a full survey. These duodenal findings resulted in a recommendation for treatment change in 38% of this group (2.4% of the total). Conclusions: Upper endoscopic survey before PEG tube placement showed a significant amount of unsuspected gastrointestinal pathology. Findings requiring biopsy, immediate treatment, or a change in medical treatment occurred in 4.2% of the cases, and these findings did not prevent PEG tube placement in any patient.

Original languageEnglish (US)
Pages (from-to)112-114
Number of pages3
JournalSurgical Endoscopy and Other Interventional Techniques
Volume16
Issue number1
DOIs
StatePublished - Jan 1 2002

Keywords

  • Endoscopic findings
  • Endoscopic survey
  • Percutaneous endoscopic gastrostomy

ASJC Scopus subject areas

  • Surgery

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