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Percutaneous endoscopic gastrostomy

Xudong Liu|Zhengqiang Yang|Shun He|Guiqi Wang
소화기인터벤션의학회 (The Society of Gastrointestinal Intervention)|2021.04|International Journal of Gastrointestinal Intervention|제10권 제2호|pp. 42-48|DOI 10.18528/ijgii210015

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ManagementComplicationsIndicationPercutaneous endoscopic gastrostomy

초록

Percutaneous endoscopic gastrostomy (PEG) is a feasible and safe technique for patients who need long-term feeding and cannot eat orally. With the increasing maturity of PEG technique, a large number of patients receive PEG tube placement every year in the world. However, PEG tube placement is not necessary in some patients, and some other patients are not evaluated strictly, leading to serious complications. In a broad sense, the mainly two indications for PEG include long-term enteral nutrition and gastric decompression. On the other hand, the main contraindications of PEG are distal intestinal obstruction, severe coagulation abnormalities, and severe infection at the PEG site. In the first section of this review, the indications and contraindications of PEG are introduced. Although PEG tube placement is a relatively safe technique, it can still cause a number of complications, including minor and major complications. Through standard management and treatment, the outcome of most patients is very good. In the second section of this review, we describe a variety of minor and major tube-related complications, and the treatment and prevention of these complications. In addition, the preparation and post-insertion care are also very important for PEG, which can reduce the incidence of complications. In the last section of this review, we describe related issues about the preparation and post-insertion care of PEG. In conclusion, PEG tube placement is a widely accepted technique that can bring benefits to the right patients.

Abstract

Percutaneous endoscopic gastrostomy (PEG) is a feasible and safe technique for patients who need long-term feeding and cannot eat orally. With the increasing maturity of PEG technique, a large number of patients receive PEG tube placement every year in the world. However, PEG tube placement is not necessary in some patients, and some other patients are not evaluated strictly, leading to serious complications. In a broad sense, the mainly two indications for PEG include long-term enteral nutrition and gastric decompression. On the other hand, the main contraindications of PEG are distal intestinal obstruction, severe coagulation abnormalities, and severe infection at the PEG site. In the first section of this review, the indications and contraindications of PEG are introduced. Although PEG tube placement is a relatively safe technique, it can still cause a number of complications, including minor and major complications. Through standard management and treatment, the outcome of most patients is very good. In the second section of this review, we describe a variety of minor and major tube-related complications, and the treatment and prevention of these complications. In addition, the preparation and post-insertion care are also very important for PEG, which can reduce the incidence of complications. In the last section of this review, we describe related issues about the preparation and post-insertion care of PEG. In conclusion, PEG tube placement is a widely accepted technique that can bring benefits to the right patients.

참고문헌 (70)

  1. Nugent B, "Enteral feeding methods for nutritional management in patients with head and neck cancers being treated with radiotherapy and", or chemotherapy, 2013, pp.2013, CD007904~
  2. Wang J, "Percutaneous endoscopic gastrostomy versus nasogastric tube feeding for patients with head and neck cancer: a systematic review", J Radiat Res, 55, pp.559~567 (2014)
  3. Gundogan K, "Outcomes of percutaneous endoscopic gastrostomy in hospitalized patients at a tertiary care center in Turkey", Eur J Clin Nutr, 68, pp.437~440 (2014)
  4. Gauderer MW, "Gastrostomy without laparotomy: a percutaneous endoscopic technique", J Pediatr Surg, 15, pp.872~875 (1980)
  5. Rahnemai-Azar AA, "Percutaneous endoscopic gastrostomy : indications, technique, complications and management", World J Gastroenterol, 20, pp.7739~7751 (2014)
  6. 김지영, "Single Center Experience with Gastrostomy Insertion in Pediatric Patients: A 10-Year Review", Pediatric Gastroenterology, Hepatology & Nutrition, 20(1), pp.34~40 (2017), 대한소아소화기영양학회
  7. 임주현, "Thirty-day mortality after percutaneous gastrostomy by endoscopic versus radiologic placement: a systematic review and meta-analysis", Intestinal research, 14(4), pp.333~342 (2016), 대한장연구학회
  8. Ralls MW, "Enteral nutrient deprivation in patients leads to a loss of intestinal epithelial barrier function", Surgery, 157, pp.732~742 (2015)
  9. Druml C, "ESPEN guideline on ethical aspects of artificial nutrition and hydration", Clin Nutr, 35, pp.545~556 (2016)
  10. Masaki S, "Comparison of long-term outcomes between enteral nutrition via gastrostomy and total parenteral nutrition in older persons with dysphagia:a propensity-matched cohort study", PLoS One, 14, pp.e0217120~ (2019)
  11. Blomberg J, "Complications after percutaneous endoscopic gastrostomy in a prospective study", Scand J Gastroenterol, 47, pp.737~742 (2012)
  12. Bassett MR, "Patterns of nutritional deficiency in head and neck cancer", Otolaryngol Head Neck Surg, 91, pp.119~125 (1983)
  13. Pulkkinen J, "Prophylactic percutaneous endoscopic gastrostomy in head and neck cancer patients: results of tertiary institute", Eur Arch Otorhinolaryngol, 271, pp.1755~1758 (2014)
  14. Lang K, "Percutaneous endoscopic gastrostomy tube placement in patients with head and neck cancer treated with radiotherapy", Cancer Manag Res, 12, pp.127~136 (2020)
  15. Kawata N, "Percutaneous endoscopic gastrostomy for decompression of malignant bowel obstruction", Dig Endosc, 26, pp.208~213 (2014)
  16. FOOD Trial Collaboration, "Poor nutritional status on admission predicts poor outcomes after stroke: observational data from the FOOD trial", Stroke, 34, pp.1450~1456 (2003)
  17. Rowat A, "Enteral tube feeding for dysphagic stroke patients", Br J Nurs, 24, pp.138~145 (2015)
  18. Corrigan ML, "Nutrition in the stroke patient", Nutr Clin Pract, 26, pp.242~252 (2011)
  19. Pamela Sarkar, "Percutaneous Endoscopic Gastrostomy Tube Insertion in Neurodegenerative Disease: A Retrospective Study and Literature Review", Clinical Endoscopy, 50(3), pp.270~278 (2017), 대한소화기내시경학회
  20. "10 facts on dementia" (2016)[URL]
  21. Humbert IA, "Early deficits in cortical control of swallowing in Alzheimer's disease", J Alzheimers Dis, 19, pp.1185~1197 (2010)
  22. Roden DF, "Causes of dysphagia among different age groups: a systematic review of the literature", Otolaryngol Clin North Am, 46, pp.965~987 (2013)
  23. Goldberg LS, "The role of gastrostomy tube placement in advanced dementia with dysphagia: a critical review", Clin Interv Aging, 9, pp.1733~1739 (2014)
  24. Akkersdijk WL, "Percutaneous endoscopic gastrostomy for patients with severe cerebral injury", Injury, 29, pp.11~14 (1998)
  25. Itkin M, "Multidisciplinary practical guidelines for gastrointestinal access for enteral nutrition and decompression from the Society of Interventional Radiology and American Gastroenterological Association (AGA) Institute, with endorsement by Canadian Interventional Radiological Association (CIRA) and Cardiovascular and Interventional Radiological Society of Europe (CIRSE)", Gastroenterology, 141, pp.742~765 (2011)
  26. Cui N, "Clinical features and advantages of a novel percutaneous endoscopic gastrostomy method", Med Sci Monit, 25, pp.9651~9657 (2019)
  27. Stiegmann GV, "Endoscopic versus operative gastrostomy: final results of a prospective randomized trial", Gastrointest Endosc, 36, pp.1~5 (1990)
  28. Russell TR, "Percutaneous gastrostomy. A new simplified and cost-effective technique", Am J Surg, 148, pp.132~137 (1984)
  29. Chadha KS, "Outcomes of percutaneous endoscopic gastrostomy tube placement using a T-fastener gastropexy device in head and neck and esophageal cancer patients", Nutr Clin Pract, 25, pp.658~662 (2010)
  30. Shastri YM, "New introducer PEG gastropexy does not require prophylactic antibiotics: multicenter prospective randomized double-blind placebo-controlled study", Gastrointest Endosc, 67, pp.620~628 (2008)
  31. Bravo JG, "Percutaneous endoscopic versus surgical gastrostomy in patients with benign and malignant diseases: a systematic review and meta-analysis", Clinics (Sao Paulo), 71, pp.169~178 (2016)
  32. Schurink CA, "Percutaneous endoscopic gastrostomy: complications and suggestions to avoid them", Eur J Gastroenterol Hepatol, 13, pp.819~823 (2001)
  33. Preclik G, "Prospective, randomised, double blind trial of prophylaxis with single dose of co-amoxiclav before percutaneous endoscopic gastrostomy", BMJ, 319, pp.881~884 (1999)
  34. Dormann AJ, "Antibiotic prophylaxis in percutaneous endoscopic gastrostomy (PEG)--results from a prospective randomized multicenter trial", Z Gastroenterol, 38, pp.229~234 (2000)
  35. ASGE Standards of Practice Committee, "Antibiotic prophylaxis for GI endoscopy", Gastrointest Endosc, 81, pp.81~89 (2015)
  36. "Gastrostomy tubes: complications and their management" (2019)[URL]
  37. Blacka J, "Dwell time and functional failure in percutaneous endoscopic gastrostomy tubes:a prospective randomized-controlled comparison between silicon polymer and polyurethane percutaneous endoscopic gastrostomy tubes", Aliment Pharmacol Ther, 20, pp.875~882 (2004)
  38. Boldo-Roda E, "Reflections in front of a case of ventral hernia after PEG tube removal", Gastrointest Endosc, 62, pp.323~324 (2005)
  39. Navarro F, "Herniation through gastrostomy site: case report", Int J Surg Case Rep, 25, pp.165~166 (2016)
  40. Stathopoulos G, "Subcutaneous emphysema following PEG", Gastrointest Endosc, 37, pp.374~376 (1991)
  41. Gottfried EB, "Pneumoperitoneum following percutaneous endoscopic gastrostomy. A prospective study", Gastrointest Endosc, 32, pp.397~399 (1986)
  42. Schrag SP, "Complications related to percutaneous endoscopic gastrostomy (PEG) tubes. A comprehensive clinical review", J Gastrointestin Liver Dis, 16, pp.407~418 (2007)
  43. Larson DE, "Percutaneous endoscopic gastrostomy. Indications, success, complications, and mortality in 314 consecutive patients", Gastroenterology, 93, pp.48~52 (1987)
  44. Galat SA, "Management of premature removal of the percutaneous gastrostomy", Am Surg, 56, pp.733~736 (1990)
  45. Lynch CR, "Prevention and management of complications of percutaneous endoscopic gastrostomy (PEG) tubes", Pract Gastroenterol, 28, pp.66~76 (2004)
  46. Date RS, "Unusual complications of ballooned feeding tubes", Ir Med J, 95, pp.181~182 (2002)
  47. Warriner L, "Managing overgranulation tissue around gastrostomy sites", Br J Nurs, 21, pp.S14~S20 (2012)
  48. McClave SA, "Complications of enteral access", Gastrointest Endosc, 58, pp.739~751 (2003)
  49. Lau G, "Fatal retroperitoneal haemorrhage: an unusual complication of percutaneous endoscopic gastrostomy", Forensic Sci Int, 116, pp.69~75 (2001)
  50. 이서희, "Percutaneous Endoscopic Gastrostomy Tube Insertion-induced Superior Mesenteric Artery Injury Treated with Angiography", 대한소화기학회지, 72(6), pp.308~312 (2018), 대한소화기학회[DOI]
  51. Guloglu R, "Colon injury following percutaneous endoscopic gastrostomy tube insertion", J Laparoendosc Adv Surg Tech A, 13, pp.69~72 (2003)
  52. Karhadkar AS, "Jejunocutaneous fistula manifesting as chronic diarrhea after PEG tube replacement", J Clin Gastroenterol, 40, pp.560~561 (2006)
  53. Chaer RA, "Intrahepatic placement of a PEG tube", Gastrointest Endosc, 57, pp.763~765 (2003)
  54. Gubler C, "Liver injury during PEG tube placement: report of two cases", Gastrointest Endosc, 61, pp.346~348 (2005)
  55. Klein S, "The “buried bumper syndrome": a complication of percutaneous endoscopic gastrostomy", Am J Gastroenterol, 85, pp.448~451 (1990)
  56. El AZ, "Buried bumper syndrome: low incidence and safe endoscopic management", Acta Gastroenterol Belg, 74, pp.312~316 (2011)
  57. Grant JP, "Percutaneous endoscopic gastrostomy. Initial placement by single endoscopic technique and long-term follow-up", Ann Surg, 217, pp.168~174 (1993)
  58. Finucane TE, "Use of tube feeding to prevent aspiration pneumonia", Lancet, 348, pp.1421~1424 (1996)
  59. MacLean AA, "Abdominal wall necrotizing fasciitis from dislodged percutaneous endoscopic gastrostomy tubes: a case series", Am Surg, 70, pp.827~831 (2004)
  60. Cruz I, "Incidence of abdominal wall metastasis complicating PEG tube placement in untreated head and neck cancer", Gastrointest Endosc, 62, pp.708~711 (2005)
  61. Volkmer K, "Metastasis of an esophageal carcinoma at a PEG site--case report and review of the literature", Zentralbl Chir, 134, pp.481~485 (2009)
  62. Janik TA, "Analysis of factors affecting the spontaneous closure of a gastrocutaneous fistula", J Pediatr Surg, 39, pp.1197~1199 (2004)
  63. Gay-Chevallier S, "Closure of non-healing gastrocutaneous fistula after percutaneous endoscopic gastrostomy by endoscopic submucosal dissection and over-the-scope clip", Endoscopy, 51, pp.E125~E126 (2019)
  64. Bechtold ML, "Early versus delayed feeding after placement of a percutaneous endoscopic gastrostomy: a meta-analysis", Am J Gastroenterol, 103, pp.2919~2924 (2008)
  65. Szary NM, "Enteral feeding within three hours after percutaneous endoscopic gastrostomy placement:a meta-analysis", J Clin Gastroenterol, 45, pp.e34~e38 (2011)
  66. Vyawahare MA, "A comparative observational study of early versus delayed feeding after percutaneous endoscopic gastrostomy", Indian J Gastroenterol, 32, pp.366~368 (2013)
  67. Roveron G, "Clinical practice guidelines for the nursing management of percutaneous endoscopic gastrostomy and jejunostomy (PEG", PEJ) in adult patients: an executive summary, 2018, pp.45, 326~334
  68. Sriram K, "Prophylactic locking of enteral feeding tubes with pancreatic enzymes", JPEN J Parenter Enteral Nutr, 21, pp.353~356 (1997)
  69. Bischoff SC, "ESPEN guideline on home enteral nutrition", Clin Nutr, 39, pp.5~22 (2020)
  70. Waxman I, "PEG ileus. A new cause of small bowel obstruction", Dig Dis Sci, 36, pp.251~254 (1991)

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