Korean J Gastroenterol.  2022 Jan;79(1):12-21. 10.4166/kjg.2021.086.

Nutritional Impact of Percutaneous Endoscopic Gastrostomy: A Retrospective Single-center Study

• Jung SO
• Moon HS
• Kim TH
• Park JH
• Kim JS
• Kang SH
• Sung JK
• Jeong HY

• KMID: 2525518
• DOI: http://doi.org/10.4166/kjg.2021.086

Abstract

Background/Aims
Several conditions may cause difficulties with oral feeding. Percutaneous endoscopic gastrostomy (PEG) is commonly performed on patients who require enteral feeding for >2-3 weeks. This study examined the nutritional state of patients who required enteral feeding and underwent PEG to quantify the benefits of the procedure.
Methods
This retrospective study included patients who underwent PEG at the Chungnam National University Hospital between January 2013 and December 2018. A gastroenterologist performed all PEG procedures using the pull technique, and all patients were followed up for >3 weeks postoperatively. The BMI and lymphocyte count, along with the levels of hemoglobin, total protein, albumin, total cholesterol, BUN, and creatinine pre-PEG and between 3 weeks and 6 months post-PEG were evaluated.
Results
Overall, 151 patients (116 males; mean age 64.92 years) were evaluated. Of these patients, 112 (74.2%), 34 (22.5%), and five (3.3%) underwent PEG tube insertion because of neurological diseases, malignancy, and other conditions, respectively. The BMI and the hemoglobin, total protein, albumin, and total cholesterol levels were significantly higher post-PEG than pre-PEG.
Conclusions
These findings highlight the usefulness of PEG in the management of nutritionally poor patients with difficulties in feeding orally.

Keyword

Gastrostomy; Endoscopy; Enteral nutrition; Nutritional status

Figure

• 

  Fig. 1 Flow chart of patient enrollment. Between January 2013 and December 2018, 245 patients underwent percutaneous endoscopic gastrostomy (PEG). Eighteen patients were excluded because they had a previous history of PEG tube insertion, and 76 patients were excluded because they had no follow-up data between 3 weeks to 6 months after PEG tube insertion. One hundred fifty-one patients were enrolled as the final study group. PEG, percutaneous endoscopic gastrostomy.

• 

  Fig. 2 Percutaneous endoscopic gastrostomy (PEG) methods. (A) The transilluminated area on the abdominal wall was checked. (B) A protrusion on the abdominal wall was observed when the physician pressed the transilluminated area externally. (C) The abdomen was then punctured with a needle, and a guidewire was inserted through the puncture site. (D) The guidewire was then manipulated through the esophagus and brought out through the oral cavity using forceps. (E) Following this, adequate positioning of the PEG tube was observed by endoscopy. (F) Finally, an external bumper was fixed to the abdominal wall.

• 

  Fig. 3 Bland-Altman plots of laboratory test results and body mass index (BMI). (A) Hemoglobin level, (B) lymphocyte count, (C) total protein level, (D) albumin level, (E) total cholesterol level, (F) blood urea nitrogen level, (G) creatinine level, and (H) BMI. The levels of hemoglobin, total protein, albumin, and total cholesterol, as well as the BMI, were significantly higher post-percutaneous endoscopic gastrostomy (PEG) than pre-PEG.

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