Nasir Khokhar, Muzaffar Lateef Gill.
Percutaneous Endoscopic Gastrostomy: an eight years experience in a teritary care center in Pakistan.
Pak Postgrad Med J Jan ;14(3):137-40.

Objective: To review the experience of percutaneous endoscopic gastrostomy (PEG) tube placement and its management at a tertiary care center in Pakistan in previous 8 years. Study Design: Retrospective descriptive Cohort study. Time and Place of Study: January 1995 to January 2003 at Shifa International Hospital, Islamabad. Methods: All patients who underwent percutaneous endoscopic gastrostomy in these 8 years were included in this study. The indications, technique, complications and follow up were reviewed. Results: A total of 163 persons underwent this procedure. There were 98 (60.0%) males and 65 (40.0%) females. Age ranged from 55-76 years. One hundred fifty seven (96.0%) patients had cerebral vascular accident, four (2.5%) had Parkinson`s disease and two (1.5%) had malignancy. More than 99% procedures were successful. No procedure related mortality was noted. Mild PEG site infections were encountered in sixteen (9.8%) patients which were manageable with local treatment and oral antibiotics. Three (1.8%) patients had severe tube site infection and needed parenteral antibiotics. Tube dislodgement took place in five (3.0%) patients and had to be removed and reinserted. Thirty days follow up was uneventful with regard to the tube. Longest follow up was 736 days. Conclusion: Percutaneous endoscopic gastrostomy had proved a viable means of enteral nutrition in patient with neurological impairment. Complications were acceptable in these patients, However, patient and care giver`s education could be improved for more effective tube management, and prevention of PEG insertion site infection.

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