Benefits and risks of a percutaneous endoscopic gastrostomy (PEG) for decompression in patients with malignant gastrointestinal obstruction

2017 ◽  
Vol 25 (9) ◽  
pp. 2849-2856 ◽  
Author(s):  
Anne Dittrich ◽  
Barbara Schubert ◽  
Michael Kramer ◽  
Felicitas Lenz ◽  
Karin Kast ◽  
...  
2021 ◽  
pp. flgastro-2021-101930
Author(s):  
Ross J Porter ◽  
Alastair W McKinlay ◽  
Emma L Metcalfe

IntroductionChronic gastrointestinal obstruction can precipitate a constellation of symptoms including nausea, vomiting, abdominal distension and pain that negatively impact on health-related quality of life. Decompression via venting gastrostomy can offer symptomatic relief but safety and efficacy data are sparse. This study characterises the diverse venting percutaneous endoscopic gastrostomy (vPEG) cohort at our tertiary referral centre and defines the safety and efficacy of this procedure.MethodsPatients undergoing vPEG between May 2012 and June 2020 were identified from a prospectively maintained database and demographic, procedure-related and mortality data were extracted. Retrospective analysis of case notes provided data on patient symptoms. Last follow-up was May 2021.Results27 patients (median age 63, range 18–90 years) underwent vPEG insertion. The majority of vPEGs were for patients with obstruction secondary to locally advanced or metastatic malignancy (n=21/27, 77.8%). Six procedures were performed for benign disease (n=6/27, 22.2%). No patients developed the recognised serious complications of bleeding, perforation or peritonitis from vPEG insertion. Symptoms of nausea (p=0.006), vomiting (p<0.001), abdominal distension (p<0.001) and abdominal pain (p=0.002) were improved following vPEG. Pain beyond the expected postprocedural discomfort was associated with a lower number of days survived postprocedure (p=0.026).ConclusionvPEG can be a safe and efficacious palliative intervention for benign and malignant chronic gastrointestinal obstruction. Severe postprocedural pain should be promptly investigated to exclude a potential complication. A defined clinical strategy for assessing and managing these patients would facilitate wider recognition of the benefits of vPEG and improve the safety profile in centres with more limited experience.


2020 ◽  
Vol 04 (03) ◽  
pp. 311-322
Author(s):  
Robert J. Litwin ◽  
Johanna L. Chan ◽  
Steven Y. Huang

AbstractMalignant bowel obstruction (MBO) is a relatively common condition affecting patients with advanced malignancy. Therapeutic interventions should be aimed at maintaining quality of life. Given the lack of prospective controlled studies in this patient population, patient management is often based on local practice patterns and anecdotal experience. To foster a collaborative approach among the members of the patient care team involving internal medicine, oncology, palliative care, clinical nutrition, surgery, gastroenterology, and interventional radiology physicians, it is important to improve our understanding of MBO. The purpose of this article is to describe the clinical presentation, pathophysiology, as well as medical, surgical, and nonsurgical palliative options available to patients with MBO for purposes of decompression and nutrition.


Sign in / Sign up

Export Citation Format

Share Document