The Sky Blue Method as a Screening Test to Detect Misplacement of Percutaneous Endoscopic Gastrostomy Tube at Exchange

Abstract

Background During tube exchange for percutaneous endoscopic gastrostomy (PEG),

Retrospective analyses of complications associated with transcutaneous replacement of percutaneous gastrostomy and jejunostomy feeding devices

“…The mean (Ϯ SD) number of replacements in the PEG group was 3.55 Ϯ 3.65 (range [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20], and that in the DPEJ group was 3.02 Ϯ 2.65 (range 1-12). The reasons for device replacement are shown in Table 2.…”

“…It is also reported that the dye test is useful for the detection of misplacement, but there have been some false-negative cases reported with the use of this method as well. 18 Multiple methods for treating fistula disruptions have been reported, including placement of a new PEG adjacent to the previous stoma. 17,19 However, we use an endoscopic approach through the skin level fistula opening by using an ultrathin endoscope.…”

Percutaneous Endoscopic Gastrostomy Tube Replacement Unexpected Serious Events

“…Cases of severe complications—including peritonitis and death—following established (>30 days) gastrostomy tube replacement have been previously described 2 , 3 . The frequency of these events is considered low, although not precisely measured; reported rates range from 0.4% to 7.3%, in the past decade's literature 4 , 5 . In our unit—with a workload of approximately 50 and 100 initial PEG tube placements and replacements, respectively per year—we have experienced 3 cases of peritonitis in patients with an established PEG track within a period of 7 years.…”

Effectiveness of outpatient percutaneous endoscopic gastrostomy replacement using esophagogastroduodenoscopy and propofol sedation

“…Non-endoscopic methods to determine correct catheter placement include insufflation of air, indigocarmine solutions, or ultrasound [19][20][21] . Suzuki et al [20] reported that PEG catheter misplacement was detected at a frequency of 0.4% in 961 patients using indigocarmine solution. Therefore, PEG replacement using EGD would improve the safety of PEG replacement, independent of the technical difficulty.…”