Enteral Access: Percutaneous Endoscopic Gastrostomy, Gastrostomy–Jejunostomy, and Jejunostomy

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Abstract

Endoscopic approaches for enteral feeding access are often the preferred methods for long-term nutritional support. Compared to parenteral nutrition, enteral feeding provides physiological and structural benefits to the gastrointestinal tract, which in turn have systemic benefits. Additionally, endoscopic modalities are less invasive than surgical approaches, thereby reducing complication rates and duration of hospital stay. Percutaneous endoscopic gastrostomy (PEG) was first introduced in 1980 and served as a cornerstone for the development of percutaneous endoscopic gastrojejunostomy (PEG-J), and percutaneous endoscopic jejunostomy (PEJ). These procedures are commonly performed today for patients with various chronic, traumatic, or malignant conditions and who are in need of nutritional support or decompression. Although enteral access provides many benefits, understanding its indications and limitations is critical for performing these procedures safely and effectively. This chapter provides an overview of current knowledge and practices in the rapidly evolving field of endoscopic enteral access, with emphasis on patient selection, preoperative considerations, technical conducts, and avoiding complications.

Keywords

Percutaneous endoscopic gastrostomy Percutaneous endoscopic gastrostomy–jejunostomy Percutaneous endoscopic jejunostomy Indications Complications Technique Enteral access Enteral nutrition 

Abbreviations

PEG

Percutaneous endoscopic gastrostomy

PEG-J

Percutaneous endoscopic gastrostomy–jejunostomy

PEJ

Percutaneous endoscopic jejunostomy

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Copyright information

© SAGES 2016

Authors and Affiliations

  1. 1.Department of SurgeryUniversity of Nevada School of MedicineLas VegasUSA

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