Gastrointestinal: Late complication of percutaneous endoscopic gastrostomy

Feasibility of the Cut‐and‐Push Method for Removing Large‐Caliber Soft Percutaneous Endoscopic Gastrostomy Devices

“…Although 5 remnants were not collected from feces, no cases of intestinal obstruction were noted (abdominal pain, absolute constipation, abdominal tenderness, nausea, or vomiting) during the study. Some alarming cases reported obstruction or perforation due to the inner flange embedded within the intestinal wall several months after the procedure 8 – 12 . Therefore, we recognize that a follow‐up period of 1 month might underestimate the real hazards of the cut‐and‐push technique.…”

“…So far, few studies have been conducted demonstrating the safety of the cut‐and‐push method of PEG removal up to 15 French (Fr) caliber 5 – 7 . However, concerns with this method arose from reports of severe complications 8 – 12 . Many queries with the technique are pending, and well‐established indications and limits are far from being defined.…”

Removal of percutaneous endoscopic gastrostomy tubes in adults using the “cut and push” method: A systematic review

“…Median time to presentation was 9 weeks. The majority of complications occurred within six months or less with only three complications presenting after six months ( 10,24,26) . In many cases complications occurred within a month or less ( 9,13,20,21,23,27,28,31,(33)(34)(35) ).…”

“…There were 21 records that reported complications post CP in 24 patients with a wide range of age and diagnosis (see Table One). Of these 15 were elective CP ( 12,13,20,21,(27)(28)(29)(30)(31)(32)(33)(34)(35) ); three were CP following failed traction removal of the PEG ( 11 22, 23 ); two were elective CP due to the inability to perform a gastroscopy secondary to oesophageal stricture ( 10,24 ).…”

“…It is also of note that 15 of the 24 case reports were elective CP. Three reports were CP after failed traction removal ( 11,22,23 ), three reports were unintentional CP secondary to the PEG breaking ( 20,25,26 ), two reports were of oesophageal obstruction where CP was the only option as it was not possible to perform endoscopic removal ( 10,24 ), and one case reported CP after a failed endoscopic removal attempt ( 9 ). It is possible that in some of these cases CP was the best option for the patient.…”