How Are Decisions Made About The Use of Percutaneous Endoscopic Gastrostomy for Long-Term Nutritional Support?

Although enteral feeding by nasal gastric tube is popular for the patients who have a swallowing disability and require long-term nutritional support, but have intact gut, this tube sometimes causes aspiration pneumonia or esophageal ulcer. For these patients, conventional techniques for performance of a feeding gastrostomy made by surgical laparotomy have been used so far. However, these patients are frequently poor anesthetic and operative risks. Percutaneous endoscopic gastrostomy (PEG) which can be accomplished with local anesthesia and without the necessity for laparotomy has become popular in the clinical treatment for these patients. PEG was performed in 31 cases, percutaneous endoscopic duodenostomy (PED) in 1 case, and percutaneous endoscopic jejunostomy (PEJ) in 2 cases. All patients were successfully placed, and no major complication and few minor complications (9%) were experienced in this procedure. After this procedure, some patients could discharge their sputa easily and their pneumonia subsided. PED and PEJ for the patients who had previously received gastrostomy could also be done successfully with great care. Our experience suggests that PEG, PED, and PEJ are rapid, safe, and useful procedures for the patients who have poor anesthetic or poor operative risks.

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A prospective descriptive study to evaluate the impact of percutaneous endoscopic gastrostomy in patients who require nutritional support

International Surgery Journal ◽

10.18203/2349-2902.isj20184075 ◽

2018 ◽

Vol 5 (10) ◽

pp. 3282 ◽

Cited By ~ 1

Author(s):

Ann Sunny ◽

Venkatanarasimhan N. S. ◽

Anil Kumar

Keyword(s):

Percutaneous Endoscopic Gastrostomy ◽

Nutritional Support ◽

Major Complication ◽

Descriptive Study ◽

Endoscopic Gastrostomy ◽

Acceptable Method ◽

The Impact ◽

Better Than

Background: Patients who are unable to consume orally often require some form of nutritional support. Enteral is always better than the parenteral route. Enteral feeds via traditional nasogastric tube or nasojejunal route have been used for short term feeding but for long term management of these patients percutaneous endoscopic gastrostomy is a better option. It does not require an operating room and has less morbidity associated with it.Methods: We did a prospective descriptive study to look at the role of percutaneous endoscopic gastrostomy (PEG) in providing nutritional support to patients and the morbidity associated with this procedure.Results: In this study, 83% of the patients needed PEG for head and neck cancers prior to radiotherapy and chemotherapy. Most of our patients had no complications due to the procedure (70%). There was only one major complication of necrotizing fasciitis, the rest were all minor complications. The nutritional parameters checked at the beginning and at the end of the study were not statistically significant, for example weight, serum albumin and hemoglobin but all these parameters of the study patients were stable.Conclusions: Authors found that long-term enteral feeding via PEG is a safe, effective, easy-to-apply, and highly acceptable method with minimal complications.

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Direct percutaneous endoscopic jejunostomy performed with gastroscope

Journal of Digestive Endoscopy ◽

10.4103/0976-5042.129986 ◽

2013 ◽

Vol 04 (03) ◽

pp. 090-092

Author(s):

Ajay P. Choksi ◽

Keyur C. Shah ◽

Harshad K. Parekh

Keyword(s):

Small Bowel ◽

Percutaneous Endoscopic Gastrostomy ◽

Enteral Feeding ◽

Nutritional Support ◽

Feeding Tube ◽

Endoscopic Gastrostomy ◽

Gastric Feeding ◽

Endoscopic Placement ◽

Percutaneous Endoscopic Jejunostomy

AbstractWhile percutaneous endoscopic gastrostomy (PEG) is a well-known approach for achieving enteral feeding, direct percutaneous endoscopic jejunostomy (DPEJ) is a technique that allows endoscopic placement of percutaneous/transabdominal feeding tube directly into the jejunum. It offers a non-surgical alternative for postpyloric enteral feeding for long-term nutritional support when gastric feeding is not technically possible or is inappriopriate. Conventionally DPEJ is done with pediatric colonoscope or small bowel enteroscope. Here, we report a case where DPEJ was accomplished with gastroscope.

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