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Endoscopic ultrasound‐guided percutaneous endoscopic gastrostomy
Author(s) -
BaileMaxía Sandra,
MedinaPrado Lucía,
Bozhychko Maryana,
MangasSanjuan Carolina,
Ruiz Francisco,
Compañy Luis,
Martínez Juan,
Antonio Casellas Juan,
Aparicio José Ramón
Publication year - 2020
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.13677
Subject(s) - medicine , percutaneous endoscopic gastrostomy , gastrostomy , gastropexy , surgery , stomach , enteral administration , percutaneous , endoscopic ultrasound , endoscopy , peg ratio , radiology , parenteral nutrition , finance , economics
Percutaneous endoscopic gastrostomy (PEG) is the method of choice for feeding and nutritional support in patients with a normal gastrointestinal function who require long‐term enteral nutrition. We report our experience regarding an alternative endoscopic ultrasound (EUS)‐guided PEG technique. A retrospective clinical experience case series study was conducted from January 2019 to November 2019 at a tertiary center. Adult patients deemed unfit for conventional PEG due to absence of transillumination or previous gastric surgery were enrolled. An EUS target was created by filling a glove with saline and placing it in the abdomen. EUS was performed and the target identified from the stomach. The abdominal wall was punctured from the stomach and a guidewire was advanced. The guidewire was knotted to a string, which was passed into the stomach and drawn back through the mouth. The procedure was continued following the traditional technique. Four patients underwent EUS‐PEG in our center during the study period. Mean age was 65 years and 50% were male. Two patients (50%) had a body mass index over 30. PEG indications were tongue malignancies (50%), cerebrovascular disease (25%) and dementia (25%). One patient had a Roux‐en‐Y gastric bypass and percutaneous endoscopic jejunostomy was performed. Technical success rate was 100% and no complications occurred. This case series shows that the EUS‐guided PEG technique is a safe alternative in patients deemed unfit for conventional PEG.