Affiliation:
1. Division of Gastroenterology and Hepatology Harry S. Truman Memorial Veterans’ Hospital Columbia Missouri USA
2. Division of Gastroenterology and Hepatology, School of Medicine University of Missouri Columbia Missouri USA
3. Department of Medicine, College of Medicine University of Illinois‐Peoria Peoria Illinois USA
Abstract
AbstractBackgroundInitiation of feeding after percutaneous endoscopic gastrostomy (PEG) placement has been debated. Randomized controlled trials (RCTs) have been performed on early feeding compared with delayed feeding after PEG placement with varying results. Therefore, a meta‐analysis was conducted examining early vs delayed feeding after placement of a PEG.MethodsA comprehensive search of databases was conducted in January 2024. Peer‐reviewed published RCTs comparing early feeding (≤4 h) with delayed feeding (>4 h) were identified and included in the meta‐analysis. Meta‐analysis was completed using pooled estimates of overall complications, individual complications, mortality ≤72 h, and number of day 1 significant gastric residual volumes.ResultsSix RCTs (n = 467) were included in the analysis. Comparison of early feeding with delayed feeding after PEG showed no statistically significant differences for overall complications (P = 0.18), mortality ≤72 h (P = 0.3), and number of day 1 significant gastric residual volumes (P = 0.05). No differences were also noted for individual complications, including vomiting, wound infection, bleeding, or diarrhea.ConclusionFeeding ≤4 h after PEG have no differences in minor and major complications compared with that of delayed feeding. Early feeding ≤4 h is safe and should be recommended in future guidelines.