Equipment Design ; Gastrostomy ; instrumentation ; methods ; Humans

Since it was described in 1980, percutaneous endoscopic gastrostomy (PEG) has been a widely used method for insertion of a gastrostomy tube in overseas patients who are unable to swallow or maintain adequate nutrition. PEG should be considered when enteral feeding is necessary for longer than 3-4 weeks in difficulty eating patients. However, this method is still not widely used in China. This article describes the indications and benefits of this method. Its possible risks, limitations, contraindications, and complications should also be considered in patients with severe diseases.
Enteral Nutrition ; instrumentation ; Gastroscopy ; methods ; Gastrostomy ; methods ; Humans ; Time Factors

OBJECTIVE: To determine the clinical value of laparoscopic cystogastrostomy in the treatment of pancreatic pseudocyst. METHODS: Twenty-one patients with pancreatic pseudocyst received total laparoscopic cystogastrostomy. The data on intra-operative bleeding, operative time, post-operative time to get out of bed, time of first flatus/bowel motion, complication and duration of hospital stay were observed and analyzed retrospective1y. RESULTS: Twenty-one patients were successfully carried out the laparoscopic surgery. The average operation time was 90(62-120) min. The blood loss was less than 100 mL in all patients. The average time of hospital stay was 8 d. After 12-18 month follow-up, all patients recovered smoothly without any complication. CONCLUSION Total laparoscopic cystogastrostomy with the posterior approach is a feasible, safe and minimal invasive procedure for pancreatic pseudocyst, which can be recommended to the clinical application.
Drainage ; Gastrostomy ; methods ; Humans ; Laparoscopy ; Pancreatic Pseudocyst ; surgery ; Retrospective Studies

Percutaneous endoscopic gastrostomy (PEG) is a well-established microinvasive procedure to provide enteral nutrition for various patients. Anesthetic intervention during PEG not only make patient feel painless but also help to guarantee the safety of patient by anesthetic monitoring. This article summarizes the recent advances in anesthetic techniques, drugs, and monitoring practices for patients under PEG.
Anesthesia ; methods ; Anesthetics ; administration & dosage ; therapeutic use ; Enteral Nutrition ; methods ; Gastroscopy ; methods ; Gastrostomy ; methods ; Humans

OBJECTIVETo assess the application of ultrathin transnasal gastroscopy in transnasal percutaneous endoscopic gastrostomy (nPEG) in patients with trimus and/or pharyngeal narrowing.

METHODSNine consecutive patients underwent PEG with the Introducer method using conventional gastroscopy (5 cases) or ultrathin transnasal gastroscopy (4 cases). Among the 4 patients undergoing nPEG, 3 received radiotherapy for nasopharyngeal cancer, including two with trimus and one with trimus and pharyngeal narrowing. The procedure time, safety, discomfort and complications in these cases were compared and evaluated.

RESULTSThe average procedure time of PEG was 17+/-3.5 min in conventional gastroscopy group and 17+/-3.1 min in nPEG group. No complications were observed in these patients, but the patients in nPEG group reported less discomfort associated with the procedure.

CONCLUSIONSUltrathin transnasal gastroscopy reduces the discomfort of the procedure and is safer than conventional gastroscopy for PEG, especially in patients with trimus and/or pharyngeal narrowing.

Aged ; Enteral Nutrition ; Female ; Gastroscopes ; Gastroscopy ; methods ; Gastrostomy ; methods ; Humans ; Male ; Middle Aged

OBJECTIVE: To demonstrate a comprehensive review of published articles regarding endoscopic ultrasound (EUS)-guided biliary drainage. MATERIALS AND METHODS: Review of studies regarding EUS-guided biliary drainage including case reports, case series and previous reviews. RESULTS: EUS-guided hepaticogastrostomy, coledochoduodenostomy and choledoantrostomy are advanced biliary and pancreatic endoscopy procedures, and together make up the echo-guided biliary drainage. Hepaticogastrostomy is indicated in cases of hilar obstruction, while the procedure of choice is the coledochoduodenostomy or choledochoantrostomy in distal lesions. Both procedures must be performed only after unsuccessful ERCPs. The indication of these procedures must be made under a multidisciplinary view while sharing information with the patient or legal guardian. CONCLUSION: Hepaticogastrostomy and coledochoduodenostomy or choledochoantrostomy are feasible when performed by endoscopists with expertise in biliopancreatic endoscopy. Advanced echo-endoscopy should currently be performed under a rigorous protocol in educational institutions.
Bile Duct Diseases/*surgery/ultrasonography ; Cholangiopancreatography, Endoscopic Retrograde ; Choledochostomy/methods ; Drainage/*methods ; Endosonography/*methods ; Gastrostomy/methods ; Humans ; *Ultrasonography, Interventional

Gastrostomy tube feeding is a common method to provide nutritional support for patients with inadequate oral intake. Gastrostomy tube feeding carries the risk for various complications, with percutaneous hemorrhage being a major complication. Gastric ulcer bleeding is a rare complication in these patients and few researchers have reported such events. There has been no case report of gastric ulcer bleeding diagnosed and treated by endoscopy through a mature gastrostomy tract in Korea. We describe here a case in which gastric ulcer bleeding was diagnosed and treated by a transgastrostomal endoscopy.
Endoscopy* ; Enteral Nutrition ; Gastrostomy ; Hemorrhage* ; Humans ; Korea ; Methods ; Nutritional Support ; Stomach Ulcer*

Malnutrition in patients with liver disease is common. Consequently, percutaneous endoscopic gastrostomy may be needed for the correction of malnutrition. Percutaneous endoscopic gastrostomy is rarely performed in patients with liver cirrhosis because of the presence of varices and coagulation abnormalities. However, if careful insertion technique along with thorough clinical assessment is undertaken, percutaneous endoscopic gastrostomy may be successfully performed in patients with liver cirrhosis. Here, we report successful application of percutaneous endoscopic gastrostomy in a patient with liver cirrhosis accompanied by both gastric and esophageal varices.
Aged ; *Endoscopy ; *Enteral Nutrition ; Esophageal and Gastric Varices/*complications ; Gastrostomy/*methods ; Humans ; Liver Cirrhosis/complications/*therapy ; Male

OBJECTIVETo report clinical experience of percutaneous endoscopic gastrostomy, duodenostomy, jejunostomy in 120 patients, focusing on its technique and indications.

METHODSOne hundred and twenty patients received percutaneous endoscopic gastrostomy, duodenostomy, jejunostomy from May 2001 to April 2004, including 75 percutaneous endoscopic gastrostomy (PEG), 42 percutaneous endoscopic jejunostomy (PEJ), 2 percutaneous endoscopic duodenostomy (PED), 1 direct percutaneous endoscopic jejunostomy (DPEJ). All tubes established by traditional pull technique.

RESULTSThe average duration of PEG was (9 +/- 4) min, PEJ (17 +/- 6) min, DPEJ 20 min, and PED was 10 and 12 min for 2 patients, respectively. Success rate of the technique was 98.4% (120/122). Major complication rate was 0.8% (1/120), and minor complication rate was 7.5% (9/120). Clinical indications: PEG, PED and PEJ were applied for long-term enteral nutritional support in 88 patients, gastrointestinal decompression in 25 patients, and transfusing external drainage bile to gastrointestinal tract in 5 patients. Two radiation enteritis patients used PEG for gastrointestinal decompression preoperatively and long-term enteral nutritional support postoperatively.

CONCLUSIONPEG, PED PEJ and DPEJ are easily handled, effective and safe, and may be widely used in clinical practice.

Adult ; Aged ; Duodenostomy ; methods ; Endoscopy, Gastrointestinal ; Enteral Nutrition ; Female ; Gastrostomy ; methods ; Humans ; Jejunostomy ; methods ; Male ; Middle Aged

PURPOSE: This study was performed to review the outcomes of gastrostomy insertion in children at our institute during 10 years. METHODS: A retrospective chart review was performed on 236 patients who underwent gastrostomy insertion from October 2005 to March 2015. We used our algorithm to select the least invasive method for gastrostomy insertion for each patient. Long-term follow-up was performed to analyze complications related to the method of gastrostomy insertion. RESULTS: Out of 236 patients, 120 underwent endoscopic gastrostomy, 79 had laparoscopic gastrostomy, and 37 had open gastrostomy procedures. The total major complication rates for endoscopic gastrostomy insertion, laparoscopic gastrostomy insertion, and open gastrostomy were 9.2%, 8.9%, and 8.1%, respectively. The most common major complication was gastroesophageal reflux requiring Nissen fundoplication (3.8%), and other complications included peritonitis (1.3%), hiatal hernia (1.3%), and bowel perforation (0.8%). Gastrostomy removal was successful in 8.6% and 5.0% of patients in the endoscopic and surgical gastrostomy groups, respectively. Gastrocutaneous fistula occurred in 60% of surgically inserted cases, requiring a second operation. CONCLUSION: This retrospective study was performed to review the outcome of gastrostomy insertion, as well as to introduce an algorithm that can be used for future cases. Further studies should be conducted to make a consensus on choosing the most appropriate method for gastrostomy insertion.
Child ; Consensus ; Fistula ; Follow-Up Studies ; Fundoplication ; Gastroesophageal Reflux ; Gastrostomy* ; Hernia, Hiatal ; Humans ; Intestinal Fistula ; Methods ; Peritonitis ; Retrospective Studies