Percutaneous endoscopic gastrostomy tube placement in a surgical training program

Background This study examines the patterns of use of percutaneous endoscopic gastrostomy (PEG) and primary open gastrostomy (Gtube) performed in a residency training program in surgery. Methods A retrospective cohort study that assesses the indications and outcomes of 317 PEGs and 75 isolated Gtubes used for gastric access between 1987 and 1997. Results The demographics and risk factors of the patients receiving Gtube and PEG were comparable. The mean number of PEGs performed per resident is currently 13 per year (mean 5 over 10 years) with a 97% PEG success rate; an 88% success rate is demonstrated for placement of jejunal extensions. Conclusions PEGs are generally preferable to Gtubes as primary procedures. Surgical residents should become competent in PEG placement by performing adequate numbers of procedures with fully trained staff.