Clinical Practice Guideline for Percutaneous Endoscopic Gastrostomy

Abstract

With an aging population, the number of patients with difficulty swallowing due to medical conditions is gradually increasing. In such cases, enteral nutrition is administered through a temporary nasogastric tube. Long-term use of a nasogastric tube leads to various complications and a decreased quality of life. Percutaneous endoscopic gastrostomy (PEG) is the percutaneous placement of a tube into the stomach, aided endoscopically, which may be an alternative to a nasogastric tube when enteral nutritional is required for 4 weeks or more. This paper is the first Korean clinical guideline for PEG. It was developed jointly by the Korean College of Helicobacter and Upper Gastrointestinal Research and led by the Korean Society of Gastrointestinal Endoscopy. These guidelines aimed to provide physicians, including endoscopists, with the indications, use of prophylactic antibiotics, timing of enteric nutrition, tube placement methods, complications, replacement, and tubes removal for PEG based on the currently available clinical evidence.

Percutaneous radiologic gastrostomy versus percutaneous endoscopic gastrostomy for enteral feeding: A systematic review and meta‐analysis

“…PEG tubes with large diameters can be inserted using this technique. 12 However, PEG tube placement in patients with obesity is challenging. 13 Moreover, in cases of malignancy located along the advancement path, there is a small but definite risk of inadvertent tumor metastasis in the gastrostomy site, a situation in which the PEG push technique or PRG should be preferred.…”

“…13 Moreover, in cases of malignancy located along the advancement path, there is a small but definite risk of inadvertent tumor metastasis in the gastrostomy site, a situation in which the PEG push technique or PRG should be preferred. 12,14 PRG was introduced in 1981 by Preshaw et al and is typically performed by radiologists. 15 Radiologic gastrostomy placement involves fluoroscopic guidance to distend the stomach with air, typically through a nasogastric tube, followed by selecting an appropriate site.…”