Percutaneous radiologic, surgical endoscopic, and percutaneous endoscopic gastrostomy/gastrojejunostomy: Comparative study and cost analysis

Jeffrey M. Barkmeier, Scott O. Trerotola, Eric A. Wiebke, Stuart Sherman, Veronica J. Harris, John J. Snidow, Matthew S. Johnson, Wendy J. Rogers, Xiao Hua Zhou

Research output: Contribution to journalArticle

83 Citations (Scopus)

Abstract

Purpose: To compare the results and costs of three different means of achieving direct percutaneous gastroenteric access. Methods: Three groups of patients received the following procedures: Fluoroscopically guided percutaneous gastrostomy/gastrojejunostomy (FPG, n = 42); percutaneous endoscopic gastrostomy/gastrojejunostomy (PEG, n = 45); and surgical endoscopic gastrostomy/gastrojejunostomy (SEG, n = 34). Retrospective review of the medical records was performed to evaluate indications for the procedure, procedure technical success, and outcome. Estimated costs were compared for each of the three procedures, using a combination of charges and materials costs. Results: Technical success was greater for FPG and SEG (100% each) than for PEG (84%, p = 0.008 vs FPG and p = 0.02 vs SEG). All patients (n = 7) who failed PEG subsequently underwent successful FPG. Success in placing a gastrojejunostomy was 91% for FPG, and estimated at 43% for PEG and 0 for SEG. Complications did not differ in frequency among groups. For gastrostomy, the average cost per successful tube was lowest in the PEG group ($1862, p = 0.02); FPG averaged $1985, and SEG $3694. SEG costs significantly more than FPG or PEG (p = 0.0001). For gastrojejunostomy, FPG averaged $2201, PEG $3158, and SEG $3045. Conclusion: Technical success for gastrostomy is higher for FPG and SEG than PEG. Though PEG is the least costly procedure, the difference is modest compared with FPG. For gastrojejunostomy, FPG offers the highest technical success rate and lowest cost. Due to high costs associated with the operating room, SEG should be reserved for those patients undergoing a concurrent surgical procedure.

Original languageEnglish
Pages (from-to)324-328
Number of pages5
JournalCardioVascular and Interventional Radiology
Volume21
Issue number4
DOIs
StatePublished - Jul 1998

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Gastrostomy
Gastric Bypass
Costs and Cost Analysis
Operating Rooms
Medical Records

Keywords

  • Comparative study
  • Cost
  • Gastrojejunostomy, percutaneous
  • Gastrostomy, percutaneous

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Percutaneous radiologic, surgical endoscopic, and percutaneous endoscopic gastrostomy/gastrojejunostomy : Comparative study and cost analysis. / Barkmeier, Jeffrey M.; Trerotola, Scott O.; Wiebke, Eric A.; Sherman, Stuart; Harris, Veronica J.; Snidow, John J.; Johnson, Matthew S.; Rogers, Wendy J.; Zhou, Xiao Hua.

In: CardioVascular and Interventional Radiology, Vol. 21, No. 4, 07.1998, p. 324-328.

Research output: Contribution to journalArticle

Barkmeier, Jeffrey M. ; Trerotola, Scott O. ; Wiebke, Eric A. ; Sherman, Stuart ; Harris, Veronica J. ; Snidow, John J. ; Johnson, Matthew S. ; Rogers, Wendy J. ; Zhou, Xiao Hua. / Percutaneous radiologic, surgical endoscopic, and percutaneous endoscopic gastrostomy/gastrojejunostomy : Comparative study and cost analysis. In: CardioVascular and Interventional Radiology. 1998 ; Vol. 21, No. 4. pp. 324-328.
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abstract = "Purpose: To compare the results and costs of three different means of achieving direct percutaneous gastroenteric access. Methods: Three groups of patients received the following procedures: Fluoroscopically guided percutaneous gastrostomy/gastrojejunostomy (FPG, n = 42); percutaneous endoscopic gastrostomy/gastrojejunostomy (PEG, n = 45); and surgical endoscopic gastrostomy/gastrojejunostomy (SEG, n = 34). Retrospective review of the medical records was performed to evaluate indications for the procedure, procedure technical success, and outcome. Estimated costs were compared for each of the three procedures, using a combination of charges and materials costs. Results: Technical success was greater for FPG and SEG (100{\%} each) than for PEG (84{\%}, p = 0.008 vs FPG and p = 0.02 vs SEG). All patients (n = 7) who failed PEG subsequently underwent successful FPG. Success in placing a gastrojejunostomy was 91{\%} for FPG, and estimated at 43{\%} for PEG and 0 for SEG. Complications did not differ in frequency among groups. For gastrostomy, the average cost per successful tube was lowest in the PEG group ($1862, p = 0.02); FPG averaged $1985, and SEG $3694. SEG costs significantly more than FPG or PEG (p = 0.0001). For gastrojejunostomy, FPG averaged $2201, PEG $3158, and SEG $3045. Conclusion: Technical success for gastrostomy is higher for FPG and SEG than PEG. Though PEG is the least costly procedure, the difference is modest compared with FPG. For gastrojejunostomy, FPG offers the highest technical success rate and lowest cost. Due to high costs associated with the operating room, SEG should be reserved for those patients undergoing a concurrent surgical procedure.",
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AB - Purpose: To compare the results and costs of three different means of achieving direct percutaneous gastroenteric access. Methods: Three groups of patients received the following procedures: Fluoroscopically guided percutaneous gastrostomy/gastrojejunostomy (FPG, n = 42); percutaneous endoscopic gastrostomy/gastrojejunostomy (PEG, n = 45); and surgical endoscopic gastrostomy/gastrojejunostomy (SEG, n = 34). Retrospective review of the medical records was performed to evaluate indications for the procedure, procedure technical success, and outcome. Estimated costs were compared for each of the three procedures, using a combination of charges and materials costs. Results: Technical success was greater for FPG and SEG (100% each) than for PEG (84%, p = 0.008 vs FPG and p = 0.02 vs SEG). All patients (n = 7) who failed PEG subsequently underwent successful FPG. Success in placing a gastrojejunostomy was 91% for FPG, and estimated at 43% for PEG and 0 for SEG. Complications did not differ in frequency among groups. For gastrostomy, the average cost per successful tube was lowest in the PEG group ($1862, p = 0.02); FPG averaged $1985, and SEG $3694. SEG costs significantly more than FPG or PEG (p = 0.0001). For gastrojejunostomy, FPG averaged $2201, PEG $3158, and SEG $3045. Conclusion: Technical success for gastrostomy is higher for FPG and SEG than PEG. Though PEG is the least costly procedure, the difference is modest compared with FPG. For gastrojejunostomy, FPG offers the highest technical success rate and lowest cost. Due to high costs associated with the operating room, SEG should be reserved for those patients undergoing a concurrent surgical procedure.

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