Indications for percutaneous endoscopic gastrostomy and procedure-related outcome

J Pediatr Gastroenterol Nutr. 2009 Nov;49(5):584-8. doi: 10.1097/MPG.0b013e31819a4e8c.


Objective: : To describe the indications and practice of percutaneous endoscopic gastrostomy (PEG) device insertion for nutritional support and to ascertain procedure-related complications and outcome.

Methods: : Observational study with prospectively collected data on children who underwent PEG-related procedures (PEG insertion, removal, or change to low profile button devices [LPBD]) for a 5-year period (2002-2006) at our centre.

Results: : Six hundred one PEG-related procedures were performed during the study period (384 insertions, 165 conversions to LPBD, 49 permanent PEG removals, and 3 PEG reinsertions). The main indications for PEG insertion were feeding difficulties associated with neurodisability (160/384; 41.6%) and congenital heart disease (CHD 115/384; 30%). Children with CHD required feeding nutritional support at an earlier age than children with neurodisability regardless of underlying cardiac condition. The age of PEG insertion was significantly different between the 2 main groups (neurodisability 3.56 years vs CHD 0.39 years; P < 0.001 [t test]). Fifty-nine patients were discharged on the same day as PEG insertion without complications (day case gastrostomy). The median time between PEG insertion to LPBD conversion was 0.83 year (0.12-3.86). Twenty-four of the 49 children having permanent PEG removal had CHD.

Conclusions: : Neurodisabilty and CHD were the main indications for PEG insertion, those with CHD requiring feeding support at an earlier age. Although CHD was an indication for PEG insertion in 30% of instances, a greater percentage of PEG removals (50%) were seen in this group indicating resolution of feeding difficulties.

MeSH terms

  • Adolescent
  • Age Factors
  • Cerebral Palsy
  • Child
  • Child, Preschool
  • Disabled Persons
  • Endoscopy / methods*
  • Gastrostomy / instrumentation*
  • Gastrostomy / methods
  • Heart Diseases / congenital
  • Heart Diseases / therapy*
  • Humans
  • Infant
  • Infant, Newborn
  • Intubation, Gastrointestinal / instrumentation*
  • Intubation, Gastrointestinal / methods
  • Nervous System Diseases / therapy*
  • Nutritional Support / instrumentation*
  • Nutritional Support / methods
  • Observation
  • Postoperative Complications
  • Prospective Studies
  • Time Factors
  • Treatment Outcome
  • Young Adult