Laparoscopic or Endoscopic Gastrostomy in Children: Comparison of Two Methods

Background and Purpose: Gastrostomy tubes are routinely placed endoscopically. However, complications are being reported with increasing frequency. To assess the relative efficacy of endoscopic and laparoscopic placement, we prospectively compared two groups of children in whom a gastrostomy tube was placed by either technique. Patients and Methods: Thirty-three gastrostomies were successively placed in 29 children. For patients with gastroesophageal reflux, an antireflux procedure was combined with a laparoscopic gastrostomy (lapG) placement (14 children). In the other cases, a percutaneous endoscopic gastrostomy (PEG) was performed (19 children). Results: The overall complication rate was 30% (37% for PEG and 21.5% for lapG). Major complications in the PEG group included fistula, irreducible restenosis, and peritonitis after button placement. Major complications in the lapG group consisted mainly of parietal infections. Conclusions: Gastrostomy tube placement is a serious operation that is associated wi...