Percutaneous radiologic and endoscopic gastrostomy: a 3-year institutional analysis of procedure performance.

Objective: The study was designed to evaluate the safety, efficacy, and usefulness of the performance of percutaneous radiologic (PRG) and endoscopic (PEG) gastrostomy.

Materials And Methods: This study involved a retrospective review of 182 percutaneous gastrostomy procedures (68 PRG, 114 PEG) performed over a 3-year period. Parameters analyzed included technical success, procedure duration, anesthetic requirements, incidental findings on endoscopy, and complications.

Results: The success rate for tube placement was higher for PRG than for PEG (100% versus 95%). PRG was subsequently performed in four of six patients in whom PEG procedures failed. Mean procedure duration was shorter for PRG than for PEG (32.9 min versus 39.1 min, p < .05). PRG was performed without conscious sedation (i.e., local anesthesia only) more frequently than was PEG (25% versus 0%, p < .001). The mean volume of doses of midazolam hydrochloride administered during PRG was two thirds of the volume of doses used during PEG. Incidental abnormalities were detected in 32 (30%) of the successful PEG procedures, 11 (10%) of which resulted in biopsy or medical therapy. No biopsy specimen showed evidence of malignancy. One (0.9%) patient received treatment other than gastric acid medication. Three (3%) major postprocedural complications occurred immediately after PEG and none (0%) occurred after PRG.

Conclusion: The significant advantages of PRG over PEG included higher success rates, shorter procedure duration, and less conscious sedation required. PRG was also successful with patients for whom PEG failed.