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경피 내시경하 위루술의 삽입과 관리

Technique, Management and Complications of Percutaneous Endoscopic Gastrostomy

양창헌|임윤정
대한소화기내시경학회 (The Korean Society Of Gastrointestinal Endoscopy)|2009.09|Clinical Endoscopy|제39권 제3호|pp. 119-124

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참고문헌

키워드

합병증Complication경장 영양Percutaneous endoscopic gastrostomyEnteral feeding경피 내시경하 위루술
주제분류내과학

초록

경피 내시경하 위루술(percutaneous endoscopic gastrostomy, PEG)은 연하 곤란으로 경구 섭취가 불가능한 환자에서 경장 영양을 할 목적으로 내시경을 이용하여 위에 관을 삽입하는 방법으로 시술이 간편하고 안전하여 널리 쓰이고 있는 방법이다. PEG를 삽입하는 환자는 대개 영양상태가 불량한 기저 질환과 고령인 경우가 많아 PEG 삽입 후 지속적인 관리가 중요하며 PEG 합병증에 대한 정확한 지식의 숙지와 빠른 대처가 PEG 삽입만큼 중요하다. 본 종설에서는 저자의 경험과 문헌 고찰, 외국 가이드라인을 참고하여 PEG에 대한 삽입, 관리 및 합병증에 대한 PEG의 길잡이를 제시하고자 한다.

Abstract

Percutaneous endoscopic gastrostomy (PEG) is a widely used method for introducing a gastrostomy tube endoscopically to enable enteral feeding in patients who are unable to eat but have a normally functioning gut. The endsopist trained in the techniques for enteral access should be equally acquired the knowledge for monitoring patients and managing the complications arising from the initial gastrostomy procedure. Optimal endoscopic technique, proper monitor, early recognition of impending complication and quick management are important because most of these patients are elderly, debilitated, and chronically ill. In this review, general information about insertion and management of PEG was described based on the our experience of PEG and review of literatures.

참고문헌 (39)

  1. A.S.P.E.N. Board of Directors and The Clinical Guidelines Task Force, "Guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients", J Parenter Enteral Nutr, 26, pp.33S~35S (2002)
  2. Löser C, "ESPEN guidelines on artificial enteral nutrition--percutaneous endoscopic gastrostomy (PEG)", Clin Nutr, 24, pp.848~861 (2005)
  3. Gauderer MW, "Gastrostomy without laparotomy: a percutaneous endoscopic technique", J Pediatr Surg, 15, pp.872~875 (1980)
  4. Ponsky JL, "Percutaneous endoscopic gastrostomy: a nonoperative technique for feeding gastrostomy", Gastrointest Endosc, 27, pp.9~11 (1981)
  5. American Gastroenterological Association, "Technical Review on Tube Feeding for Enteral Nutrition", Gastroenterology, 108, pp.1282~1301 (1995)
  6. Larson DE, "Percutaneous endoscopic gastrostomy: Indications, success, complications and mortality in 314 consecutive patients", Gastroenterology, 93, pp.48~52 (1987)
  7. ASPEN Board of Directors and the Clinical Guidelines Task Force, "Guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients", J Parenter Enteral Nutr, 26, pp.1S~138S (2002)
  8. Larson DE, "Percutaneous endoscopic gastrostomy. in: Indications, success, complications, and mortality in 314 consecutive patients", Gastroenterology, 93, pp.48~52 (1987)
  9. Sangster W, "Percutaneous endoscopic gastrostomy", Am J Surg, 155, pp.677~679 (1988)
  10. DeLegge MH, "Percutaneous endoscopic gastrostomy", Am J Gastroenterol, 102, pp.2620~2623 (2007)
  11. Gencosmanoglu R, "Percutaneous endoscopic gastrostomy: a safe and effective bridge for enteral nutrition in neurological or non-neurological conditions", Neurocrit Care, 1, pp.309~317 (2004)
  12. Colasanto JM, "Nutritional support of patients undergoing radiation therapy for head and neck cancer", Oncology, 19, pp.371~379 (2005)
  13. Pearce CB, "Enteral feeding. in: Nasogastric, nasojejunal, percutaneous endosopic gastrostomy, or jejunostomy: its indications and limitations", Postgrad Med J, 78, pp.198~204 (2002)
  14. Pennington C, "To PEG or not to PEG", Clin Med, 2, pp.250~255 (2002)
  15. Yavagal DR, "Metoclopramide for preventing pneumonia in critically ill patients receiving enteral tube feeding: a randomized controlled trial", Crit Care Med, 28, pp.1408~1411 (2000)
  16. Heyland D, "Enteral nutrition in the critically ill patient: a prospective survey", Crit Care Med, 23, pp.1055~1060 (1995)
  17. McClave SA, "Enteral tube feeding in the intensive care unit. in: Factors impeding adequate delivery", Crit Care Med, 27, pp.1252~1256 (1992)
  18. Abuksis G, "Percutaneous endoscopic gastrostomy: High mortality rates in hospitalized patients", Am J Gastroenterol, 95, pp.128~132 (2000)
  19. Adams S, "A study of problems association with the delivery of enteral feedings in critically ill patients in five ICUs in the UK", Intensive Care Med, 23, pp.261~266 (1997)
  20. Sharma VK, "Meta-analysis of randomized, controlled trials of antibiotic prophylaxis before percutaneous endoscopic gastrostomy", Am J Gastroenterol, 95, pp.3133~3136 (2000)
  21. Jafri NS, "Meta-analysis: antibiotic prophylaxis to prevent peristomal infection following percutaneous endoscopic gastrostomy", Aliment Pharmacol Ther, 25, pp.647~656 (2007)
  22. DiSario JA, "Endoscopic approaches to enteral nutritional support", Best Pract Res Clin Gastroenterol, 20, pp.605~630 (2006)
  23. Choudhry U, "Percutaneous endoscopic gastrostomy: a randomized prospective comparison of early and delayed feeding", Gastrointest Endosc, 44, pp.164~167 (1996)
  24. Holmes S, "Enteral feeding and percutaneous endoscopic gastrostomy", Nurs Stand, 18, pp.41~43 (2004)
  25. Stroud M, "British Society of Gastroenterology. in: Guidelines for enteral feeding in adult hospital patients", Gut, 52, pp.1S~12S (2003)
  26. Fang JC, "Minimizing endoscopic complications in enteral access", Gastrointest Endosc Clin N Am, 17, pp.179~196 (2007)
  27. Mullan H, "Risk of pulmonary aspiration among patients receiving enteral nutrition support", J Parenter Enteral Nutr, 16, pp.160~164 (1992)
  28. Woodcock NP, "Enteral versus parenteral nutrition: a pragmatic study", Nutrition, 17, pp.1~12 (2001)
  29. Murphy LM, "gastric residuals in tube feeding: How much is too much?", Nutr Clin Pract, 19, pp.304~306 (1999)
  30. Schrag SP, "Complications related to percutaneous endoscopic gastrostomy (PEG) tubes", J Gastrointestin Liver Dis, 16, pp.407~418 (2007)
  31. Ritchie CS, "Ethical and medicolegal issues related to percutaneous endoscopic gastrostomy placement", Gastrointest Endosc Clin N Am, 17, pp.906~815 (2007)
  32. McClave SA, "Spectrum of morbidity related to bolster placement at time of percutaneous endoscopic gastrostomy: buried bumper syndrome to leakage and peritonitis", Gastrointest Endosc Clin N Am, 17, pp.731~746 (2007)
  33. Fang JC, "Minimizing endoscopic complications in enteral access", Gastrointest Endosc Clin N Am, 17, pp.179~196 (2007)
  34. McClave SA, "Complications of enteral access", Gastrointest Endosc, 58, pp.739~751 (2003)
  35. Roberts PA, "Pneumoperitoneum after percutaneous endoscopic gastrostomy: a case report and review", J Emerg Med, 28, pp.45~48 (2005)
  36. Patwardhan N, "Gastroenteric fistula complicating percutaneous endoscopic gastrostomy", J Pediatr Surg, 39, pp.561~564 (2004)
  37. Best C, "The correct positioning and role of an external fixation device on a PEG", Nurs Times, 100, pp.50~51 (2004)
  38. Society of Gastroenterology Nurses and Associates, Inc, "The role of the nurse", associate in the placement of percutaneous endoscopic gastrostomy (PEG) tube, 2006, pp.29, 318~319
  39. Bruckstein AH, "Managing the percutaneous endoscopic gastrostomy tube", Postgrad Med, 82, pp.143~146 (1987)

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