Evidence map›Paper›PMID 37342839›Full record

ArticleWorld journal of gastrointestinal surgery2023

How far is the endoscopist to blame for a percutaneous endoscopic gastrostomy complication?

George Stavrou, Persefoni Gionga, George Chatziantoniou, Georgios Tzikos, Alexandra Menni, Stavros Panidis, Anne Shrewsbury, Katerina Kotzampassi

Open access · diamondAbstract read
In one paragraph

Article in World journal of gastrointestinal surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.5field-weighted citation impact, top 39% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

George StavrouDepartment of Surgery, Aristotle University of Thessaloniki, Thessaloniki 54636, Greece.
Persefoni GiongaDepartment of Surgery, Aristotle University of Thessaloniki, Thessaloniki 54636, Greece.
George ChatziantoniouDepartment of Surgery, Aristotle University of Thessaloniki, Thessaloniki 54636, Greece.
Georgios TzikosDepartment of Surgery, Aristotle University of Thessaloniki, Thessaloniki 54636, Greece.
Alexandra MenniDepartment of Surgery, Aristotle University of Thessaloniki, Thessaloniki 54636, Greece.
Stavros PanidisDepartment of Surgery, Aristotle University of Thessaloniki, Thessaloniki 54636, Greece.
Anne ShrewsburyDepartment of Surgery, Aristotle University of Thessaloniki, Thessaloniki 54636, Greece.
Katerina KotzampassiDepartment of Surgery, Aristotle University of Thessaloniki, Thessaloniki 54636, Greece. kakothe@yahoo.com.
Aristotle University of Thessaloniki · GR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPercutaneous endoscopic gastrostomy (PEG) is a well-established, minimally invasive, and easy to perform procedure for nutrition delivery, applied to individuals unable to swallow for various reasons. PEG has a high technical success rate of insertion between 95% and 100% in experienced hands, but varying complication rates ranging from 0.4% to 22.5% of cases.

aimTo discuss the existing evidence of major procedural complications in PEG, mainly focusing on those that could probably have been avoided, had the endoscopist been more experienced, or less self-confident in relation to the basic safety rules for PEG performance.

methodsAfter a thorough research of the international literature of a period of more than 30 years of published "case reports" concerning such complications, we critically analyzed only those complications which were considered - after assessment by two experts in PEG performance working separately - to be directly related to a form of malpractice by the endoscopist.

resultsMalpractice by the endoscopist were considered cases of: Gastrostomy tubes passed through the colon or though the left lateral liver lobe, bleeding after puncture injury of large vessels of the stomach or the peritoneum, peritonitis after viscera damage, and injuries of the esophagus, spleen, and pancreas.

conclusionFor a safe PEG insertion, the overfilling of the stomach and small bowel with air should be avoided, the clinician should check thoroughly for the proper trans-illumination of the light source of the endoscope through the abdominal wall and ensure endoscopically visible imprint of finger palpation on the skin at the center of the site of maximum illumination, and finally, the physician should be more alert with obese patients and those with previous abdominal surgery.

Indexed as

ComplicationsDoctor responsibilityPercutaneous endoscopic gastrostomy

Identifiers

PMID37342839
PMCPMC10277955
OpenAlexW4378174478

What Socratic holds

Textmetadata
LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.