Early postlaparotomy percutaneous endoscopic gastrostomy.

Percutaneous endoscopic gastrostomy (PEG) is a relatively new procedure, the indications for which are evolving. We have recently attempted PEG placement in 19 patients during the early postlaparotomy period (less than 14 days) for initiating enteral feedings or providing decompression of the gastrointestinal tract. All patients had unexpected postoperative complications, including neurologic catastrophe, recurrent obstruction of the small intestine, acute respiratory failure, enterocutaneous fistula or poor oral intake. Of 19 attempts, PEG placement was successful in 18 patients (94.7 per cent). There were no major complications; two minor complications (exit site infection) were associated with catheter placement. All PEG placed for enteral feedings were successfully used for nutritional support, and gastrointestinal decompression was accomplished in seven of eight patients requiring PEG. The results of this study demonstrate that PEG is technically feasible, safe and effective in the early postlaparotomy period in high-risk patients with complicated postoperative courses and the need for long term enteral access.