Percutaneous radiologic and endoscopic gastrostomy: a 3-year institutional analysis of procedure performance.

Abstract

The study was designed to evaluate the safety, efficacy, and usefulness of the performance of percutaneous radiologic (PRG) and endoscopic (PEG) gastrostomy. This study involved a retrospective review of 182 percutaneous gastrostomy procedures (68 PRG, 114 PEG) performed over a 3-year period. Parameters analyzed included technical success, procedure duration, anesthetic requirements, incidental findings on endoscopy, and complications. The success rate for tube placement was higher for PRG than for PEG (100% versus 95%). PRG was subsequently performed in four of six patients in whom PEG procedures failed. Mean procedure duration was shorter for PRG than for PEG (32.9 min versus 39.1 min, p < .05). PRG was performed without conscious sedation (i.e., local anesthesia only) more frequently than was PEG (25% versus 0%, p < .001). The mean volume of doses of midazolam hydrochloride administered during PRG was two thirds of the volume of doses used during PEG. Incidental abnormalities were detected in 32 (30%) of the successful PEG procedures, 11 (10%) of which resulted in biopsy or medical therapy. No biopsy specimen showed evidence of malignancy. One (0.9%) patient received treatment other than gastric acid medication. Three (3%) major postprocedural complications occurred immediately after PEG and none (0%) occurred after PRG. The significant advantages of PRG over PEG included higher success rates, shorter procedure duration, and less conscious sedation required. PRG was also successful with patients for whom PEG failed.