Advantages, Disadvantages and Problems with Percutaneous Endoscopic Gastrostomy (PEG) / 日本農村医学会雑誌

ABSTRACT

  PEG is an operation for enteral feeding. Its indications and contraindications have to be sufficiently considered with possible medical complications as well as ethical aspects taken into account. Patients who use PEG are rarely treated, managed and observed in only one department. Underlying diseases are treated in the department for psychosomatic diseases or neurosurgery. The creation and management of the stoma are done in the department of gastrointestinal disease or gastrointestinal surgery. Since the diseases are mostly chronic, patients are often referred to convalescent wards and care and welfare institutions, or discharged for care services. At the time of preparation of a PEG and during the period of its management on the ward, sufficient explanations need to be given to the patients' family members. Team management using a critical path, where staff members share the information, is very important.  Once the stoma is built, it is often managed regionally. Therefore, it is important that through academic societies or via case review meetings, or else employment of regional cooperative PEG passes, a system of close cooperation between hospitals, clinics, welfare institutions, families, and administration has to be built, so that the entire region can take care of the patients and provide support for life.