Laparoscopic-Assisted Percutaneous Endoscopic Gastrostomy Combined with CT-GC

ABSTRACT

Purpose: Despite the widespread use of percutaneous endoscopic gastrostomy (PEG) tubes, their placement may be associated with a variety of complications, including gastrocolic fistula. Materials and Methods: In total, seven high-risk individuals diagnosed using computed tomography (CT)-gastrocolonography (GC) underwent laparoscopic-assisted PEG (LAPEG) placement. Study endpoints included the success of LAPEG under local anesthetic and intravenous sedation, inability to thread the PEG tube, the eventual tube location, the number of tube adjustments needed, adverse events, the operating time, and PEG tube-related infection. Results: In total, 135 PEG procedures were performed during this study. Successful CT-GC was achieved in all 135 patients, and we successfully used a standard PEG technique to place the gastrostomy tube in 128 patients (95%). In seven patients (5%), the LAPEG technique was used because the transverse colon became interposed between the abdominal wall and the anterior wall of the stomach. LAPEG procedure-related minor complications were observed in two patients. Conclusions: LAPEG combined with CT-GC can be used for patients with difficult anatomical orientations and may minimize the risk of complications in PEG placement.

Keywords::

• percutaneous endoscopic gastrostomy (PEG)
• laparoscopic surgery
• laparoscopic-assisted PEG (LAPEG)
• iatrogenic colic perforation
• gastrocolic fistula
• CT-gastrocolonography (CT-GC)

Consent

Written informed consent was obtained from patients and the patients' relatives for the publication of this case report and any accompanying images. Copies of the written consent are available for review by the Editor-in-Chief of this journal.