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Clinical practice guidelines for percutaneous endoscopic gastrostomy.

Chung Hyun Tae1, Ju Yup Lee2, Moon Kyung Joo3

  • 1Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea.

Clinical Endoscopy
|July 10, 2023
PubMed
Summary

This guideline introduces percutaneous endoscopic gastrostomy (PEG) as an alternative to nasogastric tubes for long-term enteral nutrition. It offers evidence-based recommendations for its use in patients with swallowing difficulties.

Keywords:
EndoscopyGastrostomyGuideline

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Area of Science:

  • Gastroenterology
  • Clinical Medicine
  • Medical Device Technology

Background:

  • Increasing prevalence of swallowing difficulties in aging populations necessitates long-term enteral nutrition.
  • Nasogastric tubes, while common, are associated with complications and reduced quality of life for extended use.
  • Percutaneous endoscopic gastrostomy (PEG) offers a potential alternative for enteral feeding when needed for over four weeks.

Purpose of the Study:

  • To establish the first Korean clinical guidelines for percutaneous endoscopic gastrostomy (PEG).
  • To provide comprehensive, evidence-based recommendations for physicians regarding PEG procedures.
  • To cover indications, antibiotic prophylaxis, feeding protocols, techniques, complications, and management of PEG.

Main Methods:

  • Development of clinical guidelines through a joint effort by the Korean College of Helicobacter and Upper Gastrointestinal Research and the Korean Society of Gastrointestinal Endoscopy.
  • Systematic review of current clinical evidence pertaining to PEG procedures.
  • Consensus-based recommendations formulated for clinical practice.

Main Results:

  • The guidelines detail specific indications for PEG placement.
  • Recommendations are provided on the use of prophylactic antibiotics and the optimal timing for initiating enteral nutrition.
  • Guidance is offered on tube placement techniques, management of complications, tube replacement, and removal.

Conclusions:

  • These guidelines provide a standardized, evidence-based approach to PEG procedures in Korea.
  • Implementation of these guidelines aims to improve patient outcomes and quality of life.
  • The document serves as a crucial resource for endoscopists and physicians managing patients requiring long-term enteral nutrition.