Korean J Med.  2014 Sep;87(3):318-322. 10.3904/kjm.2014.87.3.318.

Laparoscopy-Assisted Percutaneous Endoscopic Gastrostomy in a Patient with Distorted Anatomy

• Park SH
• Lee JR
• Lim JG
• Park JH
• Yoon HS
• Lee JH
• Yu JS

• KMID: 2269242
• DOI: http://doi.org/10.3904/kjm.2014.87.3.318

Abstract

Percutaneous endoscopic gastrostomy (PEG), which was first introduced in 1980, was quickly adopted for use in pediatric and adult patients. However, problems such as severe kyphoscoliosis, interposed organs, or other forms of distorted anatomy, may prevent effective and safe PEG tube placement. In such cases, laparoscopy-assisted PEG (LAPEG) is a useful optional procedure for patients with distorted anatomy and an initial unsuccessful PEG attempt. Furthermore, less invasive measures are preferable over surgical gastrostomy. We present a 27-year-old-male patient with severe kyphoscoliosis and a history of PEG-related complications with a colocutaneous fistula appearing 10 months earlier in whom a feeding tube was successfully placed by LAPEG. There were no LAPEG-related complications in the perioperative period, either technical or metabolic. After discharge, the patient was effectively fed using the bolus method.

Keyword

Laparoscopy; Gastrostomy; Endoscopy; Kyphoscoliosis

MeSH Terms

Adult
Endoscopy
Fistula
Gastrostomy*
Humans
Laparoscopy
Perioperative Period