Percutaneous endoscopic gastrostomy and jejunostomy: Indications and techniques

Area of Science:

• Gastroenterology
• Endoscopy
• Nutritional Support

Background:

• Nutritional support is critical for patients with impaired weight maintenance.
• Oral feeding is primary, but enteral access via tubes or percutaneous devices is necessary when oral intake is insufficient.
• Percutaneous endoscopic gastrostomy (PEG) is indicated for nutritional support exceeding 4 weeks, particularly in neurological, oncological, and catabolic conditions.

Purpose of the Study:

• To review current endoscopic techniques for percutaneous gastrostomy.
• To detail indications, post-procedural follow-up, and associated adverse events (AEs) of PEG placement.
• To address ethical considerations in patients requiring PEG who cannot provide informed consent.

Main Methods:

• Review of current endoscopic techniques for percutaneous gastrostomy.
• Analysis of indications for PEG placement.
• Evaluation of post-procedural follow-up and adverse events associated with PEG.

Main Results:

• PEG is a feasible alternative for long-term nutritional support.
• Various endoscopic, radiological, and surgical techniques exist for PEG creation, each with distinct outcomes and AEs.
• Ethical challenges arise with fragile patients unable to consent.

Conclusions:

• Endoscopic PEG placement is a key method for nutritional support in specific patient populations.
• Understanding different techniques, their risks, and ethical implications is crucial for optimal patient care.
• Further research may be needed to refine techniques and address ethical dilemmas.