Persistent Ostomy Following Percutaneous Endoscopic Gastrostomy Removal: Treatment Strategies.

Q1 Medicine Current Gastroenterology Reports Pub Date : 2024-02-01 Epub Date: 2024-01-09 DOI:10.1007/s11894-023-00912-6

Alsiddig Elmahdi, Mohamed Eisa, Robert Martindale, Endashaw Omer

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Abstract

Purpose of review: The purpose of this article is to review available literature on management of persistent ostomy following PEG tube removal. We will discuss the incidence of persistent gastrocutaneous fistula (GCF) following PEG tube removal, risk factors for their development, and management strategies that have been proposed and their efficacy.

Recent findings: The use of over the scope clips (OTSC) have evolved recently in the management of gastrointestinal bleeding, perforation, and fistula closures. OTSC has become more readily available and proven to be effective and safe. Suturing devices have shown promising results. Persistent gastrocutaneous fistula following PEG removal is a rare yet serious complication that can lead to continuous skin irritation and leakage of gastric contents and acid. There are several postulated risk factors but the most important of these is duration of placement. Management can include medical therapy which has recently been shown to be somewhat effective, endoscopic therapy and surgery as a last resort. Overall, the data on GCFs is limited and further study with larger sample size is needed.

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经皮内镜胃造口术后持续造口：治疗策略。

综述目的：本文旨在回顾有关 PEG 管拔除后持续性造口管理的现有文献。我们将讨论 PEG 管拔除后持续性胃皮瘘 (GCF) 的发生率、其发生的风险因素、已提出的管理策略及其疗效：最近的研究结果：在治疗消化道出血、穿孔和瘘管闭合方面，超范围夹（OTSC）的使用有了新的发展。OTSC 越来越容易获得，并被证明是有效和安全的。缝合装置已显示出良好的效果。PEG 移除后的持续性胃皮瘘是一种罕见但严重的并发症，可导致持续的皮肤刺激和胃内容物及胃酸渗漏。有几种假定的风险因素，但其中最重要的是置管时间的长短。处理方法包括药物治疗（最近证明有一定疗效）、内窥镜治疗以及作为最后手段的手术治疗。总的来说，有关胃储气罐的数据还很有限，需要进行样本量更大的进一步研究。

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来源期刊

Current Gastroenterology Reports Medicine-Gastroenterology

CiteScore

7.80

自引率

0.00%

发文量

期刊介绍： As the field of gastroenterology and hepatology rapidly evolves, the wealth of published literature can be overwhelming. The aim of the journal is to help readers stay abreast of such advances by offering authoritative, systematic reviews by leading experts. We accomplish this aim by appointing Section Editors who invite international experts to contribute review articles that highlight recent developments and important papers published in the past year. Major topics in gastroenterology are covered, including pediatric gastroenterology, neuromuscular disorders, infections, nutrition, and inflammatory bowel disease. These reviews provide clear, insightful summaries of expert perspectives relevant to clinical practice. An Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research. We also provide commentaries from well-known figures in the field.

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