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Korean J Med > Volume 87(3); 2014 > Article
The Korean Journal of Medicine 2014;87(3): 318-322.
해부학적 이상 환자에서 시행한 복강경 유도 경피적내시경위조루술
박상훈1, 이정록1, 임종구1, 박종훈1, 윤형석1, 이정화2, 유준식3
1건국대학교 의학전문대학원 충주병원 내과
2건국대학교 의학전문대학원 충주병원 소아청소년과
3건국대학교 의학전문대학원 충주병원 외과
Laparoscopy-Assisted Percutaneous Endoscopic Gastrostomy in a Patient with Distorted Anatomy
Sang Hoon Park1, Jeong Rok Lee1, Jong Gu Lim1, Jong Hoon Park1, Hyung Suk Yoon1, Jung Hwa Lee2, Jun Sik Yu3
1Departments of Internal Medicine, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea
2Departments of Pediatrics, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea
3Departments of Surgery, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea
Corresponding Author: Jeong Rok Lee ,Tel: +82-43-840-8631, Fax: +82-43-840-8973, Email: flyingbass93@gmail.com
Received: January 14, 2014;   Revised: March 4, 2014;   Accepted: May 5, 2014.
his is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Percutaneous endoscopic gastrostomy (PEG), which was first introduced in 1980, was quickly adopted for use in pediatric and adult patients. However, problems such as severe kyphoscoliosis, interposed organs, or other forms of distorted anatomy, may prevent effective and safe PEG tube placement. In such cases, laparoscopy-assisted PEG (LAPEG) is a useful optional procedure for patients with distorted anatomy and an initial unsuccessful PEG attempt. Furthermore, less invasive measures are preferable over surgical gastrostomy. We present a 27-year-old-male patient with severe kyphoscoliosis and a history of PEG-related complications with a colocutaneous fistula appearing 10 months earlier in whom a feeding tube was successfully placed by LAPEG. There were no LAPEG-related complications in the perioperative period, either technical or metabolic. After discharge, the patient was effectively fed using the bolus method.
Keywords: Laparoscopy; Gastrostomy; Endoscopy; Kyphoscoliosis
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