Complications after percutaneous endoscopic gastrostomy in a prospective study

Scand J Gastroenterol. 2012 Jun;47(6):737-42. doi: 10.3109/00365521.2012.654404. Epub 2012 Apr 4.


Background: Insertion of a percutaneous endoscopic gastrostomy (PEG) is an increasingly common procedure in patients with nutritional needs and dysphagia. Better knowledge of rates and patterns of complications after PEG might influence decision-making.

Material and methods: The objective was to prospectively evaluate the rate of six pre-defined complications (leakage, diarrhea, constipation, abdominal pain, fever and peristomal infection) and mortality occurring within 2 months after PEG in an unselected sample of patients. All patients (n = 484) who had a PEG inserted at the hospital during the study period were included. Kaplan-Meier curves were used to estimate mortality over the first 60 days following PEG and Fisher's exact test was used to test equality of proportions.

Results: Of the 484 patients included, 85 (18%) died within 2 months after PEG insertion. The risk of early mortality was higher in the group with neurological disease than in the group with a tumor as indication (p < 0.001). After excluding mortality, the overall complication rates at 2 weeks and 2 months were 39% and 27%, respectively. The most common complications within 2 weeks were abdominal pain (13%), peristomal infection (11%), diarrhea (11%) and leakage (10%). At 2 months the most frequent complications were diarrhea (10%), leakage (8%) and peristomal infection (6%).

Conclusions: In the short-term perspective, there is a substantial risk of complications, including mortality, after PEG insertion. This should be considered during clinical decision-making and when informing the patients and caregivers.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdominal Pain / epidemiology
  • Abdominal Pain / etiology
  • Aged
  • Constipation / epidemiology
  • Constipation / etiology
  • Diarrhea / epidemiology
  • Diarrhea / etiology
  • Female
  • Fever / epidemiology
  • Fever / etiology
  • Follow-Up Studies
  • Gastroscopy*
  • Gastrostomy / methods*
  • Gastrostomy / mortality
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology*
  • Prospective Studies
  • Surgical Wound Infection / epidemiology
  • Surgical Wound Infection / etiology