Percutaneous endoscopic gastrostomy tubes: A premier clinical review

Adequate nutritional support is a critical component of patient management, particularly for individuals who are unable to sustain oral intake due to neurological, structural, or functional impairments. Percutaneous endoscopic gastrostomy (PEG) has become the preferred modality for long-term enteral access, offering a minimally invasive technique with high success rates and favorable safety outcomes. Common indications include cerebrovascular accidents, neurodegenerative disorders, dementia, cerebral palsy, head and neck malignancies, and severe dysphagia of various etiologies. This review summarizes the key clinical considerations surrounding PEG placement, including patient selection, contraindications, and preprocedural evaluation. We describe the principles of PEG insertion techniques and provide an evidence-based comparison between endoscopic, radiologic, and surgical gastrostomy methods, focusing on differences in complication rates, procedure-related morbidity, and patient suitability. Early and late complications of PEG placement are discussed in detail, with emphasis on preventive measures, timely recognition, and optimal management strategies. Additionally, we outline essential components of postprocedural care, routine monitoring, and recommended follow-up to ensure long-term tube function and patient safety.