gms | German Medical Science

27. Deutscher Krebskongress

Deutsche Krebsgesellschaft e. V.

22. - 26.03.2006, Berlin

Complications of percutaneous endoscopic gastrostomy (PEG) in palliative situation –a study of 296 patients

Meeting Abstract

  • corresponding author presenting/speaker Dieter Nürnberg - Medizinische Klinik B, Ruppiner Kliniken, Neuruppin, Deutschland
  • Sabine Uebach - Medizinische Klinik B, Ruppiner Kliniken, Neuruppin
  • Michael Peters - Medizinische Klinik B, Ruppiner Kliniken, Neuruppin
  • Ines Schade - Medizinische Klinik B, Ruppiner Kliniken, Neuruppin
  • Christoph Löschner - Medizinische Klinik B, Ruppiner Kliniken, Neuruppin
  • Stephan Menzel - Ärztehaus Potsdam

27. Deutscher Krebskongress. Berlin, 22.-26.03.2006. Düsseldorf, Köln: German Medical Science; 2006. DocPO556

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Veröffentlicht: 20. März 2006

© 2006 Nürnberg et al.
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Background: The percutaneous endoscopic gastrostomy (PEG) is an established way to provide enteral nutrition in patients which are unable to accept oral feeding for a longer time especially in paliative situation. Controversial reports on procedure-related complications have been published in recent years. Our study therefore investigated all indications and complications in a large teaching hospital during the years 2002 to 2004.

Method: All 306 PEG procedures of the last 3 years were analyzed retrospectively. The indications were classified in 5 categories (oncology, neurology, psychiatry, intensive care and other indications). Complications were classified as severe (bleeding, peritonitis, tube dislocation) which needed intervention and in non-severe complications (local infection, pain) which were treated by conventional means. Peri-interventional mortality was registered and a possible connection with the PEG procedure investigated.

Results: 296 of 306 cases were available for evaluation. 32% of the patients received a PEG for oncological reasons, 31% of indications were neurological, 21% intensive care and 12% psychiatric diseases. Non-severe complications occurred in 9.8% (29/296), severe complications in 8 cases (2.7%). All severe complications developed within 14 days, and consisted mainly in peritonitis (7 cases) due to lack of adhesion between stomach and abdominal wall respectively due to necrosis of the gastric wall. These complications led to the death of 6 patients (2% mortality). Bleeding occurred only during one PEG procedure and was successfully treated endoscopically. 66% of severe complications occurred in patients with oncological indication.

Conclusion: In our study the PEG procedure showed an overall complication rate of 12%, including 2.7% of severe complications that lead to a high mortality of these patients that usual present with multiple medical problems. Indications for PEG procedure should therefore be very well reviewed. Nevertheless the rate of complications seems to be determined by post procedure care rather than by the indication or the procedure itself.