Gastrostomy

Percutaneous

Economics

PEG ratio

Finance

Intensive care medicine

Percutaneous endoscopic gastrostomy

General surgery

Surgery

Endoscopy

Medicine

BMJ Open Gastroenterology

Percutaneousendoscopic gastrostomy is a commonly used endoscopic technique where a tube isplaced through the abdominal wall mainly to administer fluids, drugs and/orenteral nutrition. Several placement techniques are described in the literaturewith the 'pull' technique (Ponsky-Gardener) as the most popular one.Independent of the method used, placement includes a 'blind' perforation of thestomach through a small acute surgical abdominal wound. It is a generally safetechnique with only few major complications. Nevertheless these complicationscan be sometimes life-threatening or generate serious morbidity.Anarrative review of the literature of major complications in percutaneousendoscopic gastrostomy.This review was written from a clinical viewpoint focussing on prevention andmanagement of major complications and documentedscientific evidence with real cases from more than 20 years of clinical practice.Majorcomplications are rare but prevention, early recognition and popper management areimportant.

Prevention and management of major complications in percutaneous endoscopic gastrostomy