Scott J S, Edelman D S, Unger S W
Department of General Surgery, Mt. Sinai Medical Center of Greater Miami, Florida.
Am Surg. 1989 Feb;55(2):85-7.
One hundred patients underwent upper endoscopy for the placement of percutaneous endoscopic gastrostomies (PEGS) during a four year period from 1984 to 1988. These cases were retrospectively reviewed to document the need for total endoscopy during PEG. Ninety-seven per cent of the procedures were successful. In 89 per cent, a complete exam of the esophagus, stomach, and duodenum was performed, revealing pathologic findings in 59 per cent. The most common abnormalities were in the esophagus (23%) and the stomach (27%); however, a portion of the findings were also present in the duodenum (12%) and the pylorus (11%). Additional findings present in the complete esophagogastroduodenoscopy (EGD) done at the time of PEG included a five per cent incidence of gastric outlet obstruction and antral ulcers or polyps in six per cent. The breakdown of findings in the duodenum included eight per cent incidence of duodenal ulcers and four per cent incidence of duodenitis. A total of 22 per cent of the patients had some evidence of peptic ulcer disease. Many of the cases in which pathology was found required a change in medications and, when postoperative bleeding occurred after PEG, the other pathologic entity was much more likely to be the cause of the complication than the PEG. A careful and complete EGD is mandated every time a patient is scheduled for PEG.
1984年至1988年的四年间，100例患者接受了经皮内镜下胃造口术（PEG）的上消化道内镜检查。对这些病例进行回顾性分析，以记录PEG过程中进行全内镜检查的必要性。97%的手术成功。89%的患者对食管、胃和十二指肠进行了全面检查，其中59%发现了病理结果。最常见的异常位于食管（23%）和胃（27%）；然而，十二指肠（12%）和幽门（11%）也有部分发现。PEG时进行的完整食管胃十二指肠镜检查（EGD）的其他发现包括5%的胃出口梗阻发生率和6%的胃窦溃疡或息肉发生率。十二指肠的发现分类包括8%的十二指肠溃疡发生率和4%的十二指肠炎发生率。共有22%的患者有消化性溃疡病的某些证据。许多发现病理的病例需要改变用药，并且当PEG术后发生出血时，其他病理实体比PEG更有可能是并发症的原因。每次安排患者进行PEG时，都必须进行仔细和完整的EGD检查。
