26vzmnrw117
10.3205/26vzmnrw117
urn:nbn:de:0183-26vzmnrw1175
Meeting Abstract
Direct puncture versus pull-through technique in percutaneous endoscopic gastrostomy: A retrospective propensity score matched study
van de Loo
van de Loo
D.
D
Universitätsklinikum Münster, Medizinische Klinik B, Münster, Deutschland
author
Sanoubara
Sanoubara
F.
F
Universitätsklinikum Münster, Medizinische Klinik B, Münster, Deutschland
author
Meier
Meier
J. A.
JA
Universitätsklinikum Münster, Medizinische Klinik B, Münster, Deutschland
author
Reinsch
Reinsch
Y.
Y
Universitätsklinikum Münster, Medizinische Klinik B, Münster, Deutschland
author
Meden
Meden
L.
L
Universitätsklinikum Münster, Medizinische Klinik B, Münster, Deutschland
author
Klittich
Klittich
J.
J
Universitätsklinikum Münster, Medizinische Klinik B, Münster, Deutschland
author
Zishiri
Zishiri
J.
J
Universitätsklinikum Münster, Medizinische Klinik B, Münster, Deutschland
author
Peiffer
Peiffer
K.-H.
K-H
Universitätsklinikum Münster, Medizinische Klinik B, Münster, Deutschland
author
Uschner
Uschner
F. E.
FE
Universitätsklinikum Münster, Medizinische Klinik B, Münster, Deutschland
author
Rennebaum
Rennebaum
F.
F
Universitätsklinikum Münster, Medizinische Klinik B, Münster, Deutschland
author
McCoy
McCoy
M.
M
Universitätsklinikum Münster, Medizinische Klinik B, Münster, Deutschland
author
Trebicka
Trebicka
J.
J
Universitätsklinikum Münster, Medizinische Klinik B, Münster, Deutschland
author
Braden
Braden
B.
B
Universitätsklinikum Münster, Medizinische Klinik B, Münster, Deutschland
author
Praktiknjo
Praktiknjo
M.
M
Universitätsklinikum Münster, Medizinische Klinik B, Münster, Deutschland
author
German Medical Science GMS Publishing House
Düsseldorf
610
20260618
engl
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung).
M0644
117
Niederrheinisch-Westfälische Gesellschaft für Chirurgie
Gesellschaft für Gastroenterologie in Nordrhein-Westfalen e.V.
192. Jahrestagung der Niederrheinisch-Westfälischen Gesellschaft für Chirurgie, 34. Jahrestagung der Gesellschaft für Gastroenterologie
Viszeralmedizin NRW 2026
Gastroenterologie
Dortmund
20260618
20260619
117
TextBackground and objective: Percutaneous endoscopic gastrostomy (PEG) is essential for enteral feeding in patients with a variety of disorders. Direct puncture (DP) after gastropexy is suggested to reduce complication rates compared to pull-through (PT) technique. However, indications determine the choice between both techniques. In this large, retrospective propensity score matched study from a German tertiary endoscopic center, we aim to comprehensively evaluate the complication profiles of DP technique and compare it to the more frequently performed PT method stratified by indications.Method: Retrospective data of all PEG procedures from 2015 to 2024 were collected from electronic patient charts including general demographic information, comorbidities, medication, laboratory results and outcomes. Propensity score matching between DP and PT was performed (1:2) for underlying disease and current treatment of malignant diseases to reduce selection bias. Primary outcomes were occurrence of major (bleeding, pneumoperitoneum, perforation, systemic infection and tube dislodgment) and minor adverse events (pain and local infection). Secondary outcome was 60-day-mortality.Result: A total of 1002 consecutive PEG procedures (n = 178 DP, n = 816 PT, n = 8 for other techniques) were included. Overall, baseline characteristics were significantly different for underlying disease and current treatment for malignant disease in the DP group (PT: 44.1% vs. DP: 87.6%, p < 0.001). Major and minor adverse events were significantly lower in PT (PT: 32% vs. DP: 48,3%, p < 0.001).Following 1:2 propensity score matching, 513 procedures (171 DP, 342 PT) were analyzed. Baseline demographics, medication and comorbidities were not significantly different between the matched cohorts. Major (PT: 41.8% vs. DP: 47.3%, p = 0.24) and minor (PT: 11.7% vs. DP: 9.4%, p = 0.423) adverse events were similar after matching. However, tube dislodgment occurred significantly more frequently in the DP compared to the PT group (7.6% vs. 1.5%, p < 0.001).60-day-mortality was similar between PT and DP (8.5 vs. 10.5%, p = 0.449).Summary: Our results show that, except for tube dislodgment, adverse event rates are comparable between PT and DP and thus, do not confirm previous reports of reduced complication rates in DP, when matched for underlying disease. In our study different complication rates are observed with types of underlying disease. This study underlines the current ESGE recommendation to perform pull through technique if technically feasible.
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