Assessment of Patients Referred for Percutaneous Endoscopic Gastrostomy is Beneficial

Introduction: The insertion of percutaneous endoscopic gastrostomy (PEG) feeding tubes has become the procedure of choice for long-term enteral feeding. Gastroenterologists are increasingly requested to insert PEG tubes, some of which may be inappropriate or unnecessary.

Aim: To assess the proportion of patients who actually required PEG tube insertion subsequent to their referral.

Methods: Over a period of eighteen weeks, 30 patients were referred to our service for PEG insertion. Each patient was assessed by a gastroenterology registrar and consultant, and, a decision was made to either continue with naso-gastric feeding or to insert a PEG tube. All patients were followed up for a minimum of 30 days.

Results: Thirteen men and 17 women were referred with a mean age of 65.8 years. Twenty three (76.6%) had swallowing difficulties and 7(23.4%) were malnourished with an intact swallow. Following initial assessment, a PEG tube was placed in 20(60%) of these patients. After reassessment, a further 2 patients required PEG tube insertion. In total, 22 (73.3%) patients had a PEG tube inserted. During follow-up 2 patients died post-PEG insertion and mild complications were noted in 3 patients.

Conclusion: PEG tube placement and feeding is effective and well tolerated but continues to have associated complications and mortality. It appears useful to assess patients referred for this procedure, as in almost one third of referred patients, PEG placement was not the appropriate therapeutic strategy.