[Percutaneous endoscopic gastrostomy in geriatrics : Indications, technique and complications]

Area of Science:

• Gastroenterology
• Geriatric Medicine
• Medical Technology

Background:

• Percutaneous endoscopic gastrostomy (PEG) was introduced in 1979 as a minimally invasive technique for gastric fistula creation.
• The suture pull-through method for PEG insertion is widely adopted.
• There is a notable lack of scientific evidence supporting the indications for PEG in geriatric medicine.

Purpose of the Study:

• To evaluate the current indications and evidence base for percutaneous endoscopic gastrostomy (PEG) in geriatric patients.
• To address the uncertainty surrounding PEG use in the elderly population.
• To provide clarity on appropriate use cases for artificial nutrition in older adults.

Main Methods:

• Review of existing guidelines and scientific literature regarding PEG insertion in geriatric patients.
• Analysis of recommendations for tube feeding duration and nutritional support.
• Examination of contraindications and specific patient populations for PEG placement.

Main Results:

• Current guidelines do not recommend PEG insertion for patients with severe dementia and malnutrition.
• Tube feeding is primarily advised as a temporary measure for patients unable to consume oral nutrition for over 3 days.
• PEG insertion is generally recommended only when artificial nutrition is anticipated for over 3-4 weeks or when nasogastric tubes are not tolerated.

Conclusions:

• The evidence base for percutaneous endoscopic gastrostomy (PEG) indications in geriatric medicine is limited, leading to uncertainty.
• Current recommendations emphasize temporary use of tube feeding and restrict PEG use in specific patient groups.
• Further research is needed to establish clear evidence-based guidelines for PEG insertion in the elderly.