| Theme |
Percutaneous Endoscopic Gastrostomy (PEG) |
| Title |
Percutaneous Endoscopic Gastrostomy (PEG) Placement in Special Cases, Especially Post-gastrectomy |
| Author |
Toshiroh Kura |
Department of Gastroenterology, Naganuma Municipal Hospital |
| Author |
Hiroyoshi Sasaki |
Department of Gastroenterology, Naganuma Municipal Hospital |
| Author |
Yoshiki Nishihori |
Department of Gastroenterology, Naganuma Municipal Hospital |
| Author |
Yasuki Nishihori |
Department of Gastroenterology, Naganuma Municipal Hospital |
| Author |
Takeshi Maeda |
Department of Gastroenterology, Naganuma Municipal Hospital |
| Author |
Takuro Machida |
Department of Internal Medicine Section 4, Sapporo Medical University |
| [ Summary ] |
Since the number of elderly patients who have undergone partial gastrectomy has increased, the indications for percutaneous endoscopic gastrostomy (PEG), percutaneous endoscopic jejunostomy (PEJ), and percutaneous transesophageal gastro-tubing (PTEG) in the remaining stomach are expected to increase. In PEG for the remaining stomach, the puncture site is determined carefully by the finger push test and the illumination test as in regular PEG. Occasionally, X-ray fluoroscopy is used. In diagnostic punctures, the angles of the needle need to be controlled in each case. In PEJ, the most important point is to secure the puncture site. Due to the narrow lumen, careful control is required. In cases with difficult insertion, colonoscopic guidance is sometimes effective. In the management of PEJ, leak-related skin troubles are often difficult to treat. PEJ and PTEG have their own advantages and disadvantages and should be selected according to the conditions of each case. |