The efficacy and limitations of percutaneous endoscopic gastrostomy.
We analyzed 64 percutaneous endoscopic gastrostomy procedures performed by us between 1986 and 1990. Thirty patients had neurologic disease; 16 had head and neck cancers; eight had other malignancies; two had acquired immunodeficiency syndrome; and eight had other problems. Seven patients died within 30 days of complications (n = 4) or the primary illness (n = 3). Mean follow-up was 6 months; an additional patient died of aspiration and eight others died of their underlying illness. There were 19 complications (32%). Four wound complications occurred. Nine patients developed aspiration pneumonia within 3 days of the procedure, four of whom died in the hospital. Of the 24 patients with a history of aspiration, nine experienced aspiration during or after percutaneous endoscopic gastrostomy. Patients with a history of aspiration were more likely to have perioperative aspiration pneumonia, and patients who experienced aspiration were more likely to die.
Jarnagin
W R
WR
Department of Surgery, University of California, San Francisco.
Duh
Q Y
QY
Mulvihill
S J
SJ
Ridge
J A
JA
Schrock
T R
TR
Way
L W
LW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D002985:Clinical Protocols; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects / Q000592:standards*; D004868:Equipment Failure / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D005774:Gastrostomy / Q000009:adverse effects / Q000401:mortality / Q000592:standards*; D006785:Hospitals, University; D006787:Hospitals, Veterans; D006801:Humans; D008297:Male; D008875:Middle Aged; D011015:Pneumonia, Aspiration / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D012495:San Francisco / Q000453:epidemiology; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology; D015996:Survival Rate