Laparoscopic-assisted gastrostomy in 26 patients: indications and outcome at 2 years.

Laparoscopic-assisted gastrostomy using an original technique was successfully performed in 26 patients referred for nutritional support. The indications were neurological disorders of swallowing in 15, head and neck cancer in 4, and head injuries in 7. No major complications were seen in this group. One episode of temporary peritubal leakage settled after catheter change. One tube blocked after 4 months of feeding and temporary loss to follow-up. At follow-up, the tube continued to function in 7 patients, a mean of 130 days (range 45-667 days). In 7 patients recovery was sufficient to allow catheter removal at a mean of 134 days (range 56-450 days). Twelve patients died of their disease, a mean of 76 days after insertion (range 43-300). Patient tolerance and ease of care have been excellent. There is a suggestion that recovery specially in head injury patients may be enhanced. Laparoscopic-assisted gastrostomy should be considered in all patients referred for medium or long-term nutritional support.