• Margrét Brands Viktorsdóttir, Kristján Óskarsson, Anna Gunnarsdóttir, and Luther Sigurdsson.
• 1 Department of Surgery, Landspitali University Hospital , Reykjavík, Iceland .
• J Laparoendosc Adv Surg Tech A. 2015 Mar 1; 25 (3): 248-51.

AimThe aim of this study was to review the indications and the results of percutaneous endoscopic gastrostomy (PEG) procedures in Icelandic children.Patients And MethodsA retrospective review of all pediatric PEG procedures performed in Iceland in 1999-2010 was conducted. Diagnosis, demographics, complications, and body mass index were recorded.ResultsNinety-eight children (51 girls) were included. Median age was 2 years (range, 1 month-17 years). The most common diagnosis was neurological disease (56%). Median length of stay was 4 days (range, 1-189 days). Extended length of stay was not related to PEG. Before surgery, median body mass index (BMI) was 14.5 kg/m(2) (range, 9.8-20.8 kg/m(2)), and the median BMI-for-age z-score was -1.4 (range, -5.9 to 3.0). One year after surgery, median BMI was 15.3 kg/m(2) (range, 11.2-22.1 kg/m(2)), and median BMI-for-age z-score was -0.5 (range, -5.1 to 3.8). The median weight increased significantly in 1 year by 1.0 standard deviation (P<.0001; 95% confidence interval, -1.4820 to -0.7387). One hundred sixty-six complications were recorded in 65 children; 96% were minor, with the most common being granuloma formation (19%) and superficial skin infection (25%). The rate of infection was not statistically different between those who received preoperative antibiotics versus no antibiotics (P=.296). Major complications were peritonitis (n=3), esophageal tear (n=1), buried bumper (n=1), and malposition of the gastrostomy tube (n=1). Median follow-up was 47 months (range, 1-152 months). Fourteen children died (at 1 month to 3 years), but no deaths were related to PEG insertion. Twenty-seven children were without gastrostomy at follow-up. Twelve children (14%) underwent fundoplication later; 11 of them were neurologically impaired.ConclusionsPEG is a safe technique with a high complication rate, but the majority of complications are minor and easily treatable. Gastrostomy is sometimes temporary. Enteral feeding results in significant weight gain in 1 year.

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