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    Gastrostomy insertion: comparing the options--PEG, RIG or PIG?

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    Authors
    Laasch, Hans-Ulrich
    Wilbraham, L
    Bullen, K
    Marriott, Andrew S
    Lawrance, Jeremy A L
    Johnson, Richard J
    Lee, S H
    England, R E
    Gamble, G E
    Martin, D F
    Affiliation
    Academic Department of GI-Radiology, South Manchester University Hospitals NHS Trust and University of Central Lancashire, Manchester, UK. hul@smtr.nhs.uk
    Issue Date
    2003-05
    
    Metadata
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    Abstract
    AIM: To compare percutaneous endoscopic gastrostomy (PEG) with radiologically inserted gastrostomy (RIG) and assess a hybrid gastrostomy technique (per-oral image-guided gastrostomy, PIG). MATERIALS AND METHODS: Fifty PEGs and 50 RIGs performed in three centres were prospectively compared and the endoscopic findings of 200 PEGs reviewed. A fluoroscopy-guided technique was modified to place 20 F over-the-wire PEG-tubes in 60 consecutive patients. RESULTS: Technical success was 98%, 100% and 100% for PEG, RIG and PIG, respectively. Antibiotic prophylaxis significantly reduced stoma infection for orally placed tubes (p=0.02). Ten out of 50 (20%) small-bore RIG tubes blocked. Replacement tubes were required in six out of 50 PEGs (12%), 10 out of 50 RIGs (20%), but no PIGs (p<0.001). No procedure-related complications occurred. The function of radiologically placed tubes was significantly improved with the larger PIG (p<0.001), with similar wound infection rates. PIG was successful in 24 patients where endoscopic insertion could not be performed. Significant endoscopic abnormalities were found in 42 out of 200 PEG patients (21%), all related to peptic disease. Insignificant pathology was found in 8.5%. CONCLUSION: PIG combines advantages of both traditional methods with a higher success and lower re-intervention rate. Endoscopy is unlikely to detect clinically relevant pathology other than peptic disease. PIG is a very effective gastrostomy method; it has better long-term results than RIG and is successful where conventional PEG has failed.
    Citation
    Gastrostomy insertion: comparing the options--PEG, RIG or PIG? 2003, 58 (5):398-405 Clin Radiol
    Journal
    Clinical Radiology
    URI
    http://hdl.handle.net/10541/78971
    DOI
    10.1016/S0009-9260(03)00058-8
    PubMed ID
    12727170
    Type
    Article
    Language
    en
    ISSN
    0009-9260
    ae974a485f413a2113503eed53cd6c53
    10.1016/S0009-9260(03)00058-8
    Scopus Count
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