[Regional medical support by management of Percutaneous Endoscopic Gastrostomy(PEG)]

Percutaneous endoscopic gastrostomy(PEG)is useful for not only enteral nutrition but an early rehabilitation of oral intake. We perform PEG and rehabilitation consistently, and we also exchange a catheter after the patient is discharged from our hospital. Most patients undergo changing a PEG catheter at our hospital. So we can follow them for a long-term. There are four techniques to exchange a PEG catheter. We performed exchanging a catheter for 156 patients. There were no major complications to the patients. Merit of the first method, sky-blue method, is that we could change by bed side with almost no invasion. However, we could not get an image of a catheter in the stomach. By the second method, fluoroscopy, we could make an exact image, but a patient had little invasion of moving to an X-ray room, accepting contrast medium, and having Xray exposure. The third method, oral endoscopy, is most reliable for a confirmation of a catheter, but it is most invasive. The fourth method, battery type endoscopy, is less invasive than the third method. We could change a catheter by bed side and use an endoscope as a guiding introducer, and get an image of inside the stomach. We need an imaging diagnosis for getting a confirmation. A battery type endoscopy, which is easily manipulated, is expected to be widely used both in the hospital care and the home nursing care.