Retrospective Evaluation of Percutaneous Endoscopic Gastrostomy in Jamaica

Abstract

The technique of percutaneous endoscopic gastrostomy (PEG) tube placement has now replaced surgical gastrostomy as the method of choice for long-term enteral feeding. The outcomes of PEG placement have not been evaluated since its introduction to Jamaica in 1999. We performed a retrospective audit of PEG procedures performed at a major referral centre in Jamaica between January 1999 and January 2007. There were 240 PEG tubes placed in 215 patients during the study period. There was PEG-related morbidity in 5.4% of patients. The commoner complications included aspiration (2.1%), bleeding (1.3%), tube dislodgement (1.3%) and surgical site infection (0.8%). There were no reports of stomach perforation, gastro-enteric fistulae or intra-abdominal sepsis in this series. There was 1.7% mortality within one week of PEG tube placement and 9.6% mortality at 30 days. PEG placement is being performed at this institution with acceptable overall morbidity and mortality. Aspiration rates are higher than accepted, but may be reduced by the avoidance of over-sedation, minimal gastric insufflation and complete aspiration of gastric contents before the procedure.