Endoscopic percutaneous transesophageal gastrostomy, a novel approach for gastric decompression

Ajjana Techagumpuch, MD, Kanokkan Tepmalai, MD, Mahadeven D Tata, MD, Chadin Tharavej, MD, Suppa-ut Pungpapong, MD, Patpong Navicharern, MD, Suthep Udomsawaengsup, MD

Chulalongkorn university

Introduction: Long term nasogastric tube placement can lead to a lot of complications such as nasal erosion, sinusitis, oral infections and respiratory tract infections. PTEG was first decribed by H. Oishi in 1994, a method for gastric decompression in patient who are contraindicated for other procedures, by using rupture-free balloon under fluoroscope. Therefore we propose EPTEG as another option for these patients.

Method: This is a case series from 2007-2012 in Chulalongkorn University hospital. The decompressive tubes were inserted by using endoscopic and ultrasound guided technique without requiring of any special instrument. (As show in attached video)

Results: 22 patients were performed EPTEG successfully without any mortality. There were 12 females and 10 male patients and mean age was 56 years. All pateint had advanced stage cancer ( Intraabdominal cancer and one case of breast cancer) except for one patient who had recurrent GIST. Average time of procedure was 38 minutes. There were 2 cases with complication, one case had tube displacement and one case had subcutaneous emphysema which can be treated successfully by conservatively. All patients had short post operative hospital stay (Average 3-5 days) and started feeding within 24 hours after procedure.

Conclusion: This EPTEG method by using endoscopic and ultrasound guided technique is feasible and safe. It can provides precise view of procedure without requiring any specific commercial instruments which can reduces the cost of the procedure.

Session: Video ChannelDay 3

Program Number: V111