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Original Articles
Thirty-day mortality after percutaneous gastrostomy by endoscopic versus radiologic placement: a systematic review and meta-analysis
Joo Hyun Lim, Seung Ho Choi, Changhyun Lee, Ji Yeon Seo, Hae Yeon Kang, Jong In Yang, Su Jin Chung, Joo Sung Kim
Intest Res 2016;14(4):333-342.   Published online October 17, 2016
DOI: https://doi.org/10.5217/ir.2016.14.4.333
AbstractAbstract PDFPubReader
<b>Background/Aims</b><br/>

A percutaneous gastrostomy can be placed either endoscopically (percutaneous endoscopic gastrostomy, PEG) or radiologically (radiologically-inserted gastrostomy, RIG). However, there is no consistent evidence of the safety and efficacy of PEG compared to RIG. Recently, 30-day mortality has become considered as the most important surrogate index for evaluating the safety and efficacy of percutaneous gastrostomy. The aim of this meta-analysis was to compare the 30-day mortality rates between PEG and RIG.

Methods

Major electronic databases (MEDLINE, Embase, Scopus, and Cochrane library) were queried for comparative studies on the two insertion techniques of gastrostomy among adults with swallowing disturbance. The primary outcome was the 30-day mortality rate after gastrostomy insertion. Forest and funnel plots were generated for outcomes using STATA version 14.0.

Results

Fifteen studies (n=2,183) met the inclusion criteria. PEG was associated with a lower risk of 30-day mortality after tube placement compared with RIG (odds ratio, 0.60; 95% confidence interval [CI], 0.38–0.94; P=0.026). The pooled prevalence of 30-day mortality of PEG was 5.5% (95% CI, 4.0%–6.9%) and that of RIG was 10.5% (95% CI, 6.8%–14.3%). No publication bias was noted.

Conclusions

The present meta-analysis demonstrated that PEG is associated with a lower probability of 30-day mortality compared to RIG, suggesting that PEG should be considered as the first choice for long-term enteral tube feeding. Further prospective randomized studies are needed to evaluate and compare the safety of these two different methods of gastrostomy.

Citations

Citations to this article as recorded by  
  • Global Safety Outcomes of Endoscopic Gastrostomy Tube Placement Compared With Radiologic and Surgical Gastrostomy
    Rakahn Haddadin, Sushovan Guha
    Journal of Clinical Gastroenterology.2026; 60(4): 331.     CrossRef
  • Intragastric Localization as a Determinant of Peg Complications: A Comparative Analysis of Proximal and Distal Placements
    Suat Evirgen, Şirin Çetin, Şencan Acar, Abdurrahman Şahin, Yavuz Pirhan, Hakan Sivgin, Meryem Çetin
    Medicina.2026; 62(1): 196.     CrossRef
  • Factors Predicting Major Complications and Mortality in Percutaneous Endoscopic Gastrostomy: 8 Years of Experience of a Tertiary Surgery Center
    Murat Yildirim, Asim Kocabay, Bulent Koca, Ali Ihsan Saglam, Namik Ozkan
    Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2025;[Epub]     CrossRef
  • Improving 30-day mortality after radiologically inserted gastrostomy tube from 2007 to 2019: A population-based study of 15,605 patients
    Syed Shezal Hussain, Nosheen Umar, Umair Kamran, Benjamin Coupland, Fumi Varyani, Nigel Trudgill
    Clinical Nutrition ESPEN.2025; 66: 381.     CrossRef
  • The Predictive Value of Preoperative C-Reactive Protein to Albumin Ratio (CAR), Neutrophil to Lymphocyte Ratio (NLR), and Platelet to Lymphocyte Ratio (PLR) for Early Postoperative Complications Following PEG
    Suat Evirgen, Sirin Cetin
    Complications.2025; 2(3): 16.     CrossRef
  • Safety and Outcomes of Endoscopic and Radiologic Guided Placement of Percutaneous Gastrostomy Tube
    Mohamed H. Eldesouki, Khaled Elfert, Abdul-rahman Abusalim, Abdallfatah Abdallfatah, Mohammed Abusuliman, Mona A. Ali, Theodore Jr. Dacosta, Marc J. Zuckerman, Sherif E. Elhanafi
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  • Percutaneous radiologic gastrostomy versus percutaneous endoscopic gastrostomy for enteral feeding: A systematic review and meta‐analysis
    Matheus Coelho Meine, Isabela Ho Tusato, Nathalia Hoffmeister, Gilmara Coelho Meine
    Journal of Parenteral and Enteral Nutrition.2024; 48(6): 667.     CrossRef
  • Direct Percutaneous Endoscopic Gastrostomy Versus Radiological Gastrostomy in Patients Unable to Undergo Transoral Endoscopic Pull Gastrostomy
    Divyanshoo R. Kohli, Craig Smith, Omer Chaudhry, Madhav Desai, Dion DePaolis, Prateek Sharma
    Digestive Diseases and Sciences.2023; 68(3): 852.     CrossRef
  • Complications of Percutaneous Radiologic Gastrostomy Among Patients in a Tertiary Care Hospital in Riyadh, Saudi Arabia
    Najla Alrasheed, Haneen S Khair, Renad M Aljohani, Noof M Alharbi, Nahlah N Alotaibi, Shahad F AlEdrees, Aamir Omair
    Cureus.2023;[Epub]     CrossRef
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    Heather Parr, Lloyd Thomas, Prabhsimran Singh, Salma Mohammed, Khin Nu, John S. Kane, Fred Lee, Thomas Welbank, Andrew D. Hopper, Mark E. McAlindon, Elizabeth A. Williams, David S. Sanders
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    JGH Open.2022; 6(1): 57.     CrossRef
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  • The Outcomes of Nutritional Support Techniques in Patients with Gastrointestinal Cancers
    Vlad-Alexandru Ionescu, Gina Gheorghe, Ruxandra Oprita, Madalina Stan-Ilie, Raluca-Ioana Dascalu, Ondin Zaharia, Viorel Jinga, Camelia Cristina Diaconu, Gabriel Constantinescu
    Gastroenterology Insights.2022; 13(3): 245.     CrossRef
  • Improving 30-day mortality after PEG tube placement in England from 2007 to 2019: a retrospective national cohort analysis of 87,862 patients
    Umair Kamran, Pui Chi Lee, Ben Coupland, Abdullah Abbasi, Helen Steed, Sissi Ispoglou, Fumi Varyani, Nigel Trudgill
    Gastrointestinal Endoscopy.2022; 96(6): 943.     CrossRef
  • Outcomes following percutaneous endoscopic gastrostomy versus fluoroscopic procedures in the Medicare population
    Samantha Maasarani, Syed I. Khalid, Chantal Creighton, Athena J. Manatis-Lornell, Aaron L. Wiegmann, Samantha L. Terranella, Nicholas J. Skertich, Laura DeCesare, Edie Y. Chan
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  • Laparoscopic vs open insertion of feeding gastrostomy tube in adults with head and neck cancers: A case‐matched comparative study
    Balqees Omari, Huthaifa Asmer, Hani Al‐Najjar, Issa Mohamad, Omar Al‐Saraireh, Basil J. Ammori
    International Journal of Clinical Practice.2021;[Epub]     CrossRef
  • Percutaneous endoscopic gastrostomy
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    International Journal of Gastrointestinal Intervention.2021; 10(2): 42.     CrossRef
  • Scheduled percutaneous endoscopic gastrostomy tube replacement did not reduce PEG-related complications
    Wisam Sbeit, Anas Kadah, Amir Shahin, Samer Shbat, Moeen Sbeit, Tawfik Khoury
    Scandinavian Journal of Gastroenterology.2021; 56(11): 1386.     CrossRef
  • Comparative Safety of Endoscopic vs Radiological Gastrostomy Tube Placement: Outcomes From a Large, Nationwide Veterans Affairs Database
    Divyanshoo R. Kohli, Kevin F. Kennedy, Madhav Desai, Prateek Sharma
    American Journal of Gastroenterology.2021; 116(12): 2367.     CrossRef
  • ESPEN guideline on home enteral nutrition
    Stephan C. Bischoff, Peter Austin, Kurt Boeykens, Michael Chourdakis, Cristina Cuerda, Cora Jonkers-Schuitema, Marek Lichota, Ibolya Nyulasi, Stéphane M. Schneider, Zeno Stanga, Loris Pironi
    Clinical Nutrition.2020; 39(1): 5.     CrossRef
  • Technical success rate and safety of radiologically inserted gastrostomy versus percutaneous endoscopic gastrostomy in motor neuron disease patients undergoing: A systematic review and meta-analysis
    Tian-wen Yuan, Yang He, Sai-bo Wang, Peng Kong, Jun Cao
    Journal of the Neurological Sciences.2020; 410: 116622.     CrossRef
  • Predictors for 30-day mortality and complications following radiologically inserted gastrostomies: a single centre, large cohort review
    J. Delf, S. Jepson, S. Ramachandran, M. Elabassy, B. Morgan, R. Kenningham, J.H. Mullineux, J.A. Stephenson
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  • Gastropexy can be as safe as conventional percutaneous endoscopic gastrostomy (PEG), and biomarkers do not predict short-term or long-term outcomes: a 7-year follow-up audit
    Ross J Porter, Alastair W McKinlay, Emma L Metcalfe
    Frontline Gastroenterology.2020; 11(5): 364.     CrossRef
  • Early versus Delayed Feeding after Percutaneous Endoscopic Gastrostomy Placement in Children: A Meta-Analysis
    Jun Watanabe, Kazuhiko Kotani
    Children.2020; 7(9): 124.     CrossRef
  • Reducing 30-day post gastrostomy insertion mortality with a feeding issues multidisciplinary team meeting
    A. Bond, T. Conley, J. Fiske, V. Raymond, A. Young, P. Collins, M. Dibb, P.J. Smith
    Clinical Nutrition ESPEN.2020; 40: 282.     CrossRef
  • Nutritional Support of Cancer Patients without Oral Feeding: How to Select the Most Effective Technique?
    Gonçalo Nunes, Jorge Fonseca, Ana Teresa Barata, Mário Dinis-Ribeiro, Pedro Pimentel-Nunes
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  • Retrospective comparison of outcomes and associated complications between large bore radiologically inserted gastrostomy tube types
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    Ezekiel W. Toh Yoon, Kaori Yoneda, Kazuki Nishihara
    Minerva Gastroenterologica e Dietologica.2019;[Epub]     CrossRef
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    Wisam Sbeit, Anas Kadah, Amir Mari, Mahmud Mahamid, Tawfik Khoury
    Canadian Journal of Gastroenterology and Hepatology.2019; 2019: 1.     CrossRef
  • Risk factors for complications and mortality of percutaneous endoscopic gastrostomy insertion
    Gyu Young Pih, Hee Kyong Na, Ji Yong Ahn, Kee Wook Jung, Do Hoon Kim, Jeong Hoon Lee, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung
    BMC Gastroenterology.2018;[Epub]     CrossRef
  • A Systematic Review and Meta-Analysis on Outcomes and Complications of Percutaneous Endoscopic Versus Radiologic Gastrostomy for Enteral Feeding
    Denise Strijbos, Daniel Keszthelyi, Roel M.M. Bogie, Lennard P.L. Gilissen, Martin Lacko, Janneke G.J. Hoeijmakers, Christiaan van der Leij, Rogier de Ridder, Michiel W. de Haan, Ad A.M. Masclee
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  • Percutaneous Endoscopic Transgastric Jejunostomy (PEG‐J) Tube Placement for Levodopa‐Carbidopa Intrajejunal Gel Therapy in the Interventional Radiology Suite: A Long‐term Follow‐up
    Maria Valeria Saddi, Marianna Sarchioto, Giulia Serra, Daniela Murgia, Valeria Ricchi, Marta Melis, Roberta Arca, Pierpaolo Carreras, Loredana Sitzia, Sandro Zedda, Giovanni Dui, Rosario Rossi, Anna Ticca, Maurizio Melis, Giovanni Cossu
    Movement Disorders Clinical Practice.2018; 5(2): 191.     CrossRef
  • Percutaneous Radiologically-Guided Gastrostomy (PRG): Safety, Efficacy and Trends in a Single Institution
    Gerard ZX Low, Chow Wei Too, Yen Yeong Poh, Richard HG Lo, Bien Soo Tan, Apoorva Gogna, Farah Gillan Irani, Kiang Hiong Tay
    Annals of the Academy of Medicine, Singapore.2018; 47(11): 494.     CrossRef
  • 11,005 View
  • 87 Download
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Long-Term Clinical Outcome of Clostridium difficile Infection in Hospitalized Patients: A Single Center Study
Young Seok Doh, You Sun Kim, Hye Jin Jung, Young Il Park, Jin Won Mo, Hyun Sung, Kyung Jin Lee, Young Ki Seo, Jeong Seop Moon, Seong Woo Hong
Intest Res 2014;12(4):299-305.   Published online October 27, 2014
DOI: https://doi.org/10.5217/ir.2014.12.4.299
AbstractAbstract PDFPubReaderePub
<b>Background/Aims</b><br/>

Antibiotic usage and increasingly aging populations have led to increased incidence of Clostridium difficile infection (CDI) in worldwide. Recent studies in Korea have also reported increasing CDI incidence; however, there have been no reports on the long-term outcomes of CDI. We therefore investigated the long-term clinical outcomes of patients with CDI, including delayed recurrence, associated risk factors and mortality.

Methods

Hospitalized patients diagnosed with CDI at Seoul Paik Hospital between January 2007 and December 2008 were included. Their medical records were retrospectively investigated. 'Delayed recurrence' was defined as a relapse 8 weeks after a successful initial treatment. Multivariate logistic regression analysis was performed to identify risk factors for the delayed recurrence. Kaplan-Meier curves were used to analyze mortality rates.

Results

A total of 120 patients were enrolled; among them, 87 were followed-up for at least 1 year, with a mean follow-up period of 34.1±25.1 months. Delayed recurrence was observed in 17 patients (19.5%), and significant risk factors were age (over 70 years, P=0.049), nasogastric tube insertion (P=0.008), and proton pump inhibitor or H2-blocker treatments (P=0.028). The 12- and 24-month mortality rates were 24.6% and 32.5%, respectively. No deaths were directly attributed to CDI.

Conclusions

Delayed recurrence of CDI was not rare, occurring in 19.5% of the study population. Although CDI-related mortality was not reported, 2-year (32.5%) mortality rate of CDI patients implies that a CDI diagnosis may predict severe morbidity and poor prognosis of the underlying disease.

Citations

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