Prevention and management of major complications in percutaneous endoscopic gastrostomy.

ABSTRACT

BACKGROUND: Percutaneousendoscopic gastrostomy is a commonly used endoscopic technique where a tube isplaced through the abdominal wall mainly to administer fluids, drugs and/orenteral nutrition. Several placement techniques are described in the literaturewith the 'pull' technique (Ponsky-Gardener) as the most popular one.Independent of the method used, placement includes a 'blind' perforation of thestomach through a small acute surgical abdominal wound. It is a generally safetechnique with only few major complications. Nevertheless these complicationscan be sometimes life-threatening or generate serious morbidity. METHOD: Anarrative review of the literature of major complications in percutaneousendoscopic gastrostomy. RESULTS: This review was written from a clinical viewpoint focussing on prevention andmanagement of major complications and documentedscientific evidence with real cases from more than 20 years of clinical practice. CONCLUSIONS: Majorcomplications are rare but prevention, early recognition and popper management areimportant.