A recent report indicates that gastrostomy tubes (Gtubes) can be safe and useful for supplemental nutrition in children with cystic fibrosis (CF) and portal hypertension (JPGN 2013; 57: 245-47).
This small study from Australia was a retrospective study of their CF database from 1991-2011. During this timeframe, 60 CF patients had gastrostomy tubes. 7 children had CF and portal hypertension. The mean age of insertion was 10.6 years and all of these patients were pancreatic insufficient. Six of these 7 patients had percutaneous endoscopic gastrostomy (PEG); one had open surgical placement due to preexisting varices. The median length of followup was 4 years.
- No patients developed stomal varices
- One patient had minimal cellulitis in the perioperative period, otherwise no complications were noted.
- Two patients died related to advanced pulmonary disease
- Three patients developed varices during the course of their care
- Overall, there was improvement in BMI z-score at 2 years from -1.07 ± 0.87 to -0.58 ± 0.81 (p=0.05) and also at w years there was improvement in pulmonary function in 6 patients with mean FEV-1 going from 49.5 ± 12.6 to 62.3 ± 20.3 (P=0.04)
Take-home message: in a select group of 7 patients with Cystic Fibrosis and portal hypertension, gtube placement was safe and associated with better nutrition and lung function.
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