| [ Summary ] |
Since the number of elderly patients who have undergone partial gastrectomies has increased, the number of cases with indications for percutaneous endoscopic gastrostomy (PEG), percutaneous endoscopic duodenostomy (PED), percutaneous endoscopic jejunostomy (PEJ), and percutaneous transesophageal gastro-tubing (PTEG) in the remnant stomachs are expected to increase. In PEG case with remnant stomachs, puncture sites are carefully determined with the finger push test and the illumination test as in regular PEG cases. X-ray fluoroscopy is useful in such case. For diagnostic punctures, needle angles must be tailored to each case. In PEJ cases, the most important factor is securing the puncture site. Due to narrow lumens, careful control is required. For the management of PEJ, leak related skin complications are often difficult to treat. PEJ and PTEG have their own particular advantages and disadvantages and should be selected according to conditions specific each case. |