Complications of percutaneous endoscopic gastrostomy and risk factors of peristomal wound infection

Lee, Han Hyo; Shim, Ki Nam; Kwon, Jung Mi; Jung, Sung Ae; Yoo, Kwon

Abstract

BACKGROUND: Percutaneous Endoscopic Gastrostomy (PEG) is a widely used method for providing nutritional support for patients who require prolonged tube feeding. This technique is known to be a safer, more convenient, and less expensive procedure than surgical gastrostomy. Although the overall incidence of complication is low, several complications such as peristomal wound infection, bleeding, panperitonitis, gastrocolic fistula, etc. were reported. Among these complications, peristomal wound infection is common and troublesome.
METHODS
A retrospective review of medical records was conducted on patients undergoing PEG placement between January 1995 and March 2003. One hundred sixteen cases of 137 cases which were performed during this period were included, excluding 21 cases as exchanges of PEG. We reviewed the complications associated with PEG placement and analyzed the risk factors of peristomal wound infection.
RESULTS
In 61 (52.6%) of 116 cases, several complications developed after the procedure. The peristomal wound infection occurred in 37 cases (31.9%) and bleeding in 2 cases (1.7%). Mild complications included peristomal pain in 37 cases (31.9%); stomal leakage in 2 cases (1.7%); and oozing in 1 case (0.9%). The rate of wound infection was significantly higher in patients who had Diabetes mellitus (p<0.01), who had leukocytosis (p<0.05) and who had not received prophylactic antibiotics (p<0.05). But the rate was not different according to age, sex or underlying disease.
CONCLUSION
Peristomal wound infection was the most common complication of PEG. Diabetes mellitus and leukocytosis were risk factors of peristomal wound infection after PEG, and prophylactic antibiotics significantly reduced the risk of wound infection.