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KMID : 0882420140870030318
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Korean Journal of Medicine
2014 Volume.87 No. 3 p.318 ~ p.322
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Laparoscopy-Assisted Percutaneous Endoscopic Gastrostomy in a Patient with Distorted Anatomy
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Park Sang-Hoon
Lee Jeong-Rok
Lim Jong-Gu
Park Jong-Hoon
Yoon Hyung-Seok
Lee Jung-Hwa
Yu Jun-Sik
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Abstract
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Percutaneous endoscopic gastrostomy (PEG), which was first introduced in 1980, was quickly adopted for use in pediatric and adult patients. However, problems such as severe kyphoscoliosis, interposed organs, or other forms of distorted anatomy, may prevent effective and safe PEG tube placement. In such cases, laparoscopy-assisted PEG (LAPEG) is a useful optional procedure for patients with distorted anatomy and an initial unsuccessful PEG attempt. Furthermore, less invasive measures are preferable over surgical gastrostomy. We present a 27-year-old-male patient with severe kyphoscoliosis and a history of PEG-related complications with a colocutaneous fistula appearing 10 months earlier in whom a feeding tube was successfully placed by LAPEG. There were no LAPEG-related complications in the perioperative period, either technical or metabolic. After discharge, the patient was effectively fed using the bolus method.
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KEYWORD
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Laparoscopy, Gastrostomy, Endoscopy, Kyphoscoliosis
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