PERCUTANEOUS ENDOSCOPIC GASTROSTOMY: A FIVE YEAR EXPERIENCE IN OUR CENTER (1997–2002)

Autori:

TOMISLAV BRKIĆ, ROLAND PULANIĆ, ŽELJKO KRZNARIĆ, MILORAD OPAČIĆ, NADAN RUSTEMOVIĆ, VESNA VEGAR, BORIS VUCELIĆ, IRENA HRSTIĆ, SILVIJA ČUKOVIĆ ČAVKA, MARINA PREMUŽIĆ, RAJKO OSTOJIĆ, MIRJANA KALAUZ

Sažetak
Perkutanu endoskopsku gastrostomiju (PEG) prvi su opisali Gauderer i Ponsky 1979. godine. Metoda je u centar intervencijske gastroenterologije Zavoda za gastroenterologiju, Interne klinike KBC-a Rebro uvedena 1995. godine te postaje standardnim endoskopskim postupkom. Dostupna literatura pretražena je radi procjene najčešćeg indikacijskog područja, komplikacija i svrhovitosti provođenja postupka, a podaci su uspoređeni s osobnim iskustvom. Od 1. siječnja 1997. do 31. siječnja 2002. godine ukupno je postavljeno 86 PEG-ova (u 40 žena i 46 muškaraca). Najčešća indikacija bile su neurološke bolesti povezane s poremećajem gutanja (60/86). Smrtni ishod povezan s postavljanjem PEG-a nije se registrirao. Kod jednog bolesnika došlo je do otjecanja pripravka u peritonealnu šupljinu, što je zahtijevalo hitnu kiruršku laparatomiju unutar 24 sata. Kod dva bolesnika došlo je do lokalne infekcije na mjestu insercije koja je liječena antibioticima uz odstranjenje PEG-a. Antibiotska profilaksa provedena je u 65 bolesnika. Iz svojih iskustava možemo zaključiti da je perkutana endoskopska gastrostomija učinkovita i sigurna metoda u odgovarajućim kliničkim indikacijama.
Summary

Summary. Gauderer and Ponsky first described percutaneous endoscopic gastrostomy (PEG) in 1979. It was introduced as a routine method in the Division of Gastroenterology, University Hospital Rebro, Zagreb, in 1995. Over the years the number of PEG insertions has increased significantly. We reviewed the available literature and compared the results with our experience according to indications, complications and efficacy of the procedure. We inserted PEG in 86 patients from January 1, 1997 until January 31, 2002. There were 40 females and 46 males. The most frequent indication for PEG insertion was a neurological condition (60/86). There were no deaths directly related to the procedure. One patient had a leakage of PEG feeding into the peritoneal cavity that caused severe peritonitis and required urgent laparatomy within 24 hours of the PEG insertion. Two patients had local infection and the tube had to be removed. The antibiotic prophylaxis has been given to 65 patients. Our experience confirms that PEG is a relatively safe and well tolerated procedure.

Volumen: 11-12, 2003

Liječ Vjesn 2003;125:292–295

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