Brief Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastrointest Endosc. Feb 16, 2012; 4(2): 45-49
Published online Feb 16, 2012. doi: 10.4253/wjge.v4.i2.45
Effectiveness of outpatient percutaneous endoscopic gastrostomy replacement using esophagogastroduodenoscopy and propofol sedation
Akira Horiuchi, Yoshiko Nakayama, Masashi Kajiyama, Naoki Tanaka
Akira Horiuchi, Yoshiko Nakayama, Masashi Kajiyama, Naoki Tanaka, Digestive Disease Center, Showa Inan General Hospital, Komagane, 399-4117 Matsumoto, Japan
Yoshiko Nakayama, Department of Pediatrics, Shinshu University School of Medicine, Matsumoto 390-8621, Japan
Naoki Tanaka, Department of Metabolic Regulation, Shinshu University Graduate School of Medicine, Matsumoto 390-8621, Japan
Author contributions: Horiuchi A, Nakayama Y and Kajiyama M acquired the data; Horiuchi A and Tanaka N analyzed and interpreted the data; Horiuchi A drafted the manuscript; Horiuchi A, Nakayama Y, Kajiyama M and Tanaka N made the revision and final approval of the version to be published.
Correspondence to: Akira Horiuchi, MD, Chief, Digestive Disease Center, Showa Inan General Hospital, 3230 Akaho, Komagane 399-4117, Japan. horiuchi.akira@sihp.jp
Telephone: +81-265822121 Fax: +81-265822118
Received: June 12, 2011
Revised: November 23, 2011
Accepted: February 6, 2012
Published online: February 16, 2012
Abstract

AIM: To evaluate the effectiveness of outpatient percutaneous endoscopic gastrostomy (PEG) replacement using esophagogastroduodenoscopy (EGD) and propofol sedation.

METHODS: We retrospectively assessed the outcome and complications of consecutive patients referred for PEG replacement which was performed using EGD under propofol sedation in the outpatient setting. The success rate, the mean dose of propofol, procedure time, EGD findings, discharge time from endoscopy unit, respiratory depression, and complications within 72 h of the procedure were evaluated. In a subset of these patients, the blood concentrations of propofol were measured.

RESULTS: All 221 patients underwent successful PEG replacement. The mean dose of propofol was 34 mg (range, 20-60 mg) with a mean procedure time of 5.9 min (range, 3-8 min). Reflux esophagitis (12 patients), gastric ulcer (5), gastric neoplasm (2), and duodenal ulcer (1) were newly diagnosed at replacement. Discharge from endoscopy unit was possible in 100% of patients 45 min after the procedure. Only 3.6% (8) required transient supplemental oxygen. No complications occurred within 72 h of the procedure. During EGD the level of sedation and propofol blood concentrations after administration of propofol (30 mg) in these PEG patients corresponded to those of propofol (60 mg) in middle aged subjects (control).

CONCLUSION: PEG replacement using EGD and propofol sedationin the outpatient setting was safe and practical.

Keywords: Esophagogastroduodenoscopy, Gastrostomy, PEG, Propofol