title: Laparoscopic-Assisted Percutaneous Endoscopic Gastrostomy Combined with CT-GC.
abstract: OBJECTIVE
  Despite the widespread use of percutaneous endoscopic gastrostomy (PEG) tubes, their placement may be associated with a variety of complications, including gastrocolic fistula.
  
  
  METHODS
  In total, seven high-risk individuals diagnosed using computed tomography (CT)-gastrocolonography (GC) underwent laparoscopic-assisted PEG (LAPEG) placement. Study endpoints included the success of LAPEG under local anesthetic and intravenous sedation, inability to thread the PEG tube, the eventual tube location, the number of tube adjustments needed, adverse events, the operating time, and PEG tube-related infection.
  
  
  RESULTS
  In total, 135 PEG procedures were performed during this study. Successful CT-GC was achieved in all 135 patients, and we successfully used a standard PEG technique to place the gastrostomy tube in 128 patients (95%). In seven patients (5%), the LAPEG technique was used because the transverse colon became interposed between the abdominal wall and the anterior wall of the stomach. LAPEG procedure-related minor complications were observed in two patients.
  
  
  CONCLUSIONS
  LAPEG combined with CT-GC can be used for patients with difficult anatomical orientations and may minimize the risk of complications in PEG placement.
authors.affiliation: a Department of Surgery , Pippu Clinic , Hokkaido , Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Kato
authors.affiliation: b Department of Gastroenterology and Hepatology , Okayama University , Okayama , Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Iwasaki
authors.affiliation: c Department of Surgery , Hokuyu Hospital , Sapporo , Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Onodera
authors.affiliation: d Department of Surgery , Nihon University , Tokyo , Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Matsuda
authors.affiliation: a Department of Surgery , Pippu Clinic , Hokkaido , Japan.
authors.forename: Mineko
authors.initials: M
authors.lastname: Higuchi
authors.affiliation: a Department of Surgery , Pippu Clinic , Hokkaido , Japan.
authors.forename: Kimitaka
authors.initials: K
authors.lastname: Kato
authors.affiliation: e Department of Oral Surgery , Jikei University , Tokyo , Japan.
authors.forename: Yurina
authors.initials: Y
authors.lastname: Kato
authors.affiliation: f Department of Surgery , Asahikawa Medical University , Asahikawa , Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Taniguchi
authors.affiliation: f Department of Surgery , Asahikawa Medical University , Asahikawa , Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Furukawa
mesh_terms: D000369:Aged, 80 and over; D023881:Colonography, Computed Tomographic / Q000379:methods*; D005260:Female; D005773:Gastroscopy; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D061330:Multidetector Computed Tomography; D011446:Prospective Studies
keywords: CT-gastrocolonography (CT-GC); gastrocolic fistula; iatrogenic colic perforation; laparoscopic surgery; laparoscopic-assisted PEG (LAPEG); percutaneous endoscopic gastrostomy (PEG)