Modified percutaneous endoscopic gastrostomy (PEG) with gastropexy - earlyexperience with a new introducer technique

Objective: The Cliny PEG 13 has been available since 1999 for clinical use in the modified introducer technique in combination with endoscopically con trolled gastropexy. Data on indication, insertion technique and safety have not yet been reported in the literature. Methods: During the time period from January 1999 to June 2000, from a tota l of 457 patients receiving a PEC 27 (5.9%) subjects, in whom the insertion of a PEG by means of pull-through technique was impossible or only in comb ination with an intervention e.g. bougienage were included in this prospect ive study. Each patient received a Cliny PEC 13 by means of introducer tech nique with endoscopically controlled double gastropexy. Tumor patients with severe stenosis made up more than 90% of the cases. The insertion and 30 d ay follow-up were performed using a standardized protocol. Method-related and unrelated complications were recorded. Results: PEC inse rtion was successful in all patients without additional intervention. We di d not see any method-related complications. The peri-interventional local i nfection rate was 3.7%. One patient died during the 30-day follow-up period as a result of progression of the underlying disease. No further complicat ions occurred in long term follow-up. Conclusions: Our results show that the Cliny PEG 13 is a safe technique and an alternative to other methods and surgical procedures in patients in who m a PEG was not applicable by means of the pull-through technique. Larger c ase numbers and the use in other patient collectives will have to prove the se initial results.