Palliative Use of Percutaneous Endoscopic Gastrostomy and Percutaneous Endoscopic Cecostomy Tubes

The role of endoscopy in enteral feeding

“…PEG may also be useful to attain gastric decompression in selected individuals with benign or malignant GI dysmotility (eg, gastroparesis) or obstruction (eg, peritoneal carcinomatosis). 16 PEGJ is appropriate for patients requiring long-term EN who have severe gastroesophageal reflux, gastroparesis, or repeated tube feeding-related aspirations. 17,18 Likewise, DPEJ has indications similar to those for PEGJ but also includes patients with anatomy precluding PEG (eg, postsurgery).…”

Endoscopy in the Diagnosis and Management of Motility Disorders

“…PEG tube placement can also be used for gastric or small bowel decompression in the setting of intestinal infiltrative disorders (i.e. amyloidosis), with neuromuscular disruption of bowel motility accompanied by refractory nausea and vomiting [125].…”

“…Unlike PEG or PEJ tubes, PEC tube placement offers no route for nutritional support, but serves as a venting measure to provide symptomatic relief of abdominal bloating, pain secondary to colonic distention, and avoidance of the consequences of bowel pseudo-obstruction, such as bowel wall ischemia and perforation. Therefore, symptomatic Ogilvie's syndrome and chronic colonic inertia that are not controlled by conservative therapy may benefit from a decompression PEC [124,125]. Using the same technique and equipment as for PEG, cecostomy tube placement in these situations may offer decompression.…”

Gastroenterologische Symptomenkontrolle in der Palliativmedizin (Teil 1)

“…Die Anlage einer PEG-Ablaufsonde sollte nach Versagen der medikamentösen Therapie oder unverhältnismäßiger Beeinträchtung durch Nebenwirkungen, insbesondere Sedierung, als Option diskutiert werden [21]. Wenn möglich, sollte eine großlumige PEG von 20 Charr gelegt werden.…”