Abstract
Although enteral feeding by nasal gastric tube is popular for the patients who have a swallowing disability and require long-term nutritional support, but have intact gut, this tube sometimes causes aspiration pneumonia or esophageal ulcer. For these patients, conventional techniques for performance of a feeding gastrostomy made by surgical laparotomy have been used so far. However, these patients are frequently poor anesthetic and operative risks. Percutaneous endoscopic gastrostomy (PEG) which can be accomplished with local anesthesia and without the necessity for laparotomy has become popular in the clinical treatment for these patients. PEG was performed in 31 cases, percutaneous endoscopic duodenostomy (PED) in 1 case, and percutaneous endoscopic jejunostomy (PEJ) in 2 cases. All patients were successfully placed, and no major complication and few minor complications (9%) were experienced in this procedure. After this procedure, some patients could discharge their sputa easily and their pneumonia subsided. PED and PEJ for the patients who had previously received gastrostomy could also be done successfully with great care. Our experience suggests that PEG, PED, and PEJ are rapid, safe, and useful procedures for the patients who have poor anesthetic or poor operative risks.
Highlights
MATERIALS AND METHODSPatients unable to take oral alimentation require enteral After careful determination that no other method of alifeeding by nasogastric tubes
With the endoscope in place in the stomach, the pacal gastrostomy were being made by surgical laparotomy. tient was rolled into the supine position and the stomach
Percutaneous endoscopic doscope is deflected to the anterior surface of the gastrostomy (PEG) has become an accepted procedure
Summary
Patients unable to take oral alimentation require enteral After careful determination that no other method of alifeeding by nasogastric tubes. With the room lights dimmed, the entive risks For these patients, percutaneous endoscopic doscope is deflected to the anterior surface of the gastrostomy (PEG) has become an accepted procedure. As the tapered dilator was being pulled through the anterior abdominal wall, the bumper end of the gastrostomy tube was delivered safely through the oropharynx. After placement ofthe gastrostomy tube into the patient, endoscopy must be performed to verify proper positioning of the bumper against the gastric mucosa. We carefully chose the puncture site, and we used the same procedure for these patients They had no major or minor complications. For these patients, we carefully decided the puncture site using contact media. We had 4 such cases and we achieved successful results without any trouble (Figs. 5 and 6)
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