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World J Gastroenterol. 2013 Nov 21;19(43):7696-700. doi: 10.3748/wjg.v19.i43.7696.

Laparoscopy-assisted percutaneous endoscopic gastrostomy enables enteral nutrition even in patients with distorted anatomy.

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  • 1Adam Hermanowicz, Ewa Matuszczak, Marta Komarowska, Elzbieta Jarocka-Cyrta, Jerzy Wojnar, Wojciech Debek, Department of Pediatric Surgery, Medical University of Bialystok, 15-001 Bialystok, Poland.



To analyzed whether laparoscopy-assisted percutaneous endoscopic gastrostomy (PEG) could be a valuable option for patients with complicated anatomy.


A retrospective analysis of twelve patients (seven females, five males; six children, six young adults; mean age 19.2 years) with cerebral palsy, spastic quadriparesis, severe kyphoscoliosis and interposed organs and who required enteral nutrition (EN) due to starvation was performed. For all patients, standard PEG placement was impossible due to distorted anatomy. All the patients qualified for the laparoscopy-assisted PEG procedure.


In all twelve patients, the laparoscopy-assisted PEG was successful, and EN was introduced four to six hours after the PEG placement. There were no complications in the perioperative period, either technical or metabolic. All the patients were discharged from the hospital and were then effectively fed using bolus methods.


Laparoscopy-assisted PEG should become the method of choice for gastrostomy tube placement and subsequent EN if PEG placement cannot be performed safely.


Interposed organs; Laparoscopy-assisted percutaneous endoscopic gastrostomy; Malnutrition; Percutaneous endoscopic gastrostomy; Severe kyphosis

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