Outcomes of percutaneous endoscopic gastrostomy versus radiologically inserted gastrostomy tube insertion at a tertiary hospital

SummaryBackground and aimsPercutaneous endoscopic gastrostomy (PEG) and radiologically inserted gastrostomy (RIG) techniques are common methods for inserting a gastrostomy tube to provide nutrition. The aim of this study was to compare the outcomes between PEG and RIG placements at a tertiary referral centre.MethodsA retrospective review was conducted on all patients who had an initial PEG or RIG inserted at our institution between January 2007 and April 2009. Basic demographics, indication for insertion, peri- and post-procedural complications, tube dislodgment, tube discontinuation and death were compared.ResultsA total of 177 gastrostomy insertions in 175 patients (PEG: 80, RIG: 97) were included with a median follow up of 405 days (4–939). Baseline characteristics were similar between groups. There were no deaths related to insertion and only one major complication of peritonitis. Stomal site infection was the most common post-procedural complication [PEG: 14%, RIG:13%]. Tube dislodgment was significantly higher in the RIG group [PEG: 5 (6%), RIG:38 (39%), p < 0.005] with RIG having an odds ratio of 58 (95%CI 5–619, p < 0.001) for dislodgment on multivariate analysis. Other complications occurred with similar frequency between groups: pneumonia [PEG: 5%, RIG: 4%]; and bleeding [PEG: 1%, RIG:1%]. The 30 day and 1 year mortality rates were similar between the groups [PEG: 4%, RIG:5%; and PEG: 23%, RIG:27% respectively] as was gastrostomy tube discontinuation rates.ConclusionsBoth PEG and RIG insertion techniques compare favourably in terms of the majority of major and minor complications and long-term outcomes. However tube dislodgment rates are significantly higher following RIG insertion supporting an endoscopic approach where possible to minimise the risk of tube malposition resulting in peritoneal contamination.