经皮内镜下胃/空肠造口术并发症的预防与治疗

Percutaneous endoscopic gastrostomy and jejunostomy: methods for prevention and management of complications

目的 :重点探讨经皮内镜下胃肠造口术并发症的预防及治疗。 方法 :对 2 0 0 2年 1 0月至 2 0 0 3年 1 2月间85例恶性肿瘤病人共行 88例次经皮内镜下胃造口 (PEG)和经皮内镜下空肠造口 (PEJ) ,回顾性统计并发症的发生情况。所有PEG/J均采用拉出法。 结果 :85例病人PEG/J术后无操作相关死亡 ,无严重并发症 ,但微小并发症发生率为 8.2 % (7/ 85 )。 7例病人发生 8次微小并发症 ,分别为切口感染 2例、导管断裂 2例、导管尖端移位 2例、导管缠绕 1例、导管渗漏 1例 ,均通过非手术治疗后治愈。 结论 :经皮内镜下胃 /空肠造口术操作简便、安全 。

Objectives: Although the placement of percutaneous endoscopic gastrostomy/jejunostomy(PEG/J) is a technically simple procedure, the surgeon must be aware of the range of complications that can occur with PEG/J. We review our experience with PEG/J focusing on the complications as well as strategies for the prevention and management of these complications. Methods: A retrospective review of the records of patients who underwent PEG/J between October 2001 and December 2003 was conducted. A total of 85 cancer patients were identified. Complications associated with PEG/J were identified. All PEG/J were performed using the pull technique. Results: There was no mortality and major complication associated with the procedure. Minor complications occurred in 7 patients (8.2%). These included incisional infection (2), tube breakage(2), J catheter translocation (2), J catheter twist (1) and tube leakage (1). Conclusions: The review of our experience with PEG/J tube placement revealed a low complication rate. Appropriate perioperative management was the key to control the complications.