Endoscopic holder–assisted percutaneous endoscopic gastrostomy placement: results of a prospective, randomized comparison study

BackgroundWe developed a new method of endoscope holder–assisted percutaneous endoscopic gastrostomy (PEG) placement requiring only a single physician.ObjectiveThis study compared the feasibility and safety of the new method with the conventional pull method of PEG performed by 2 physicians.DesignProspective, randomized comparison study.SettingRural municipal hospital.PatientsEighty consecutive patients with dysphagia.InterventionsPatients were randomized to receive PEG placement by a single physician using the endoscope holder (40 patients) or by 2 physicians using the conventional pull method (40 patients).Main Outcome MeasurementsThe success rate, duration, and complications of both methods were scored.ResultsThe success rate of PEG by either method was similar (98%) using the endoscope holder compared with 100% with the conventional method. The duration of both endoscopic procedures was also similar (12.9 ± 2 and 11.5 ± 2 minutes) (P = .43). No major complication occurred with either procedure. There was 1 death within 30 days (of aspiration pneumonia) 3 days after conventional PEG placement.LimitationsThe number of patients evaluated is small.ConclusionsEndoscope holder–assisted PEG placement allows a single physician to perform all the important aspects of pull PEG placement under direct vision without assistance from another specially trained individual. The method appears to be as feasible and safe as the conventional pull method.