Percutaneous Endoscopic Gastrostomy (PEG). A New Procedure Comes of Age

Our cumulative literature review suggests PEG is a simple, relatively safe, and cost-effective means of establishing enteral access for patients who qualify for long-term nutritional support. Tube placement can be achieved in 98% of patients, usually within 15 to 30 minutes without general anesthesia. The gastrostomy catheter can be easily removed when treatment is ended and conveniently replaced if accidentally dislodged. Complications occur in approximately 17% of patients, but only 3.0% are regarded as serious. No procedure-related deaths have been reported. PEG as the initial choice for feeding tube placement followed by surgical gastrostomy in patients in whom PEG is unsuccessful is a reasonable approach to nutritional management in appropriate patients. PEG for purposes of chronic gastrointestinal decompression and internalization of biliary drainage holds promise but requires further evaluation.