Feeding Tube Placement: Jejunostomy or Percutaneous Gastrostomy Tube

Percutaneous endoscopic gastrostomy (PEG) is a surgical method of placing a tube into the stomach without having to perform an open operation on the abdomen (open laparotomy).

It is indicated in patients who have difficulty swallowing or are unable to take food by mouth. It is the most common endoscopic procedure and is a safe and effective way to provide food, liquids and medications directly into the stomach. The purpose of PEG is to maintain adequate nutrition and to feed those patients who cannot swallow food.

It can be performed by a surgeon, otolaryngologist (ENT specialist), radiologist or gastroenterologist (GI specialist). Avoid drinking or eating 8 hours before the procedure.

The procedure is performed under local anesthesia and the throat is numbed. An endoscope, a thin flexible tube with a tiny light and camera on the end, is placed into the mouth. It is then advanced through the esophagus, a tube leading from the mouth to the stomach and then into the stomach. A small incision is made in the skin of the abdomen over the stomach and then a tube (known as PEG tube or feeding tube) for feeding is pushed through the skin into the stomach. The endoscope is used to ensure the correct positioning of the tube into the stomach. The tube is sutured or tied in place to the skin.

Patients can go home the day of the procedure or the next day. The procedure takes less time, carries less risk and is preferable to a surgical gastrostomy. Gastrostomy is a surgical opening through the abdominal wall into the stomach for placement of a feeding tube.

The tubes can last for months or years. If they become broken down or clogged over a long period of time, they might need to be replaced.

Possible complications can occur with PEG tube placement which may include pain at the PEG site, leakage of nutritional liquids around the tube site that are infused and dislodgement or malfunction of the tube. Other complications include infection, aspiration (inhalation of gastric contents into the lungs), bleeding and perforation (a tiny hole that develops in the bowel wall) and need to convert to an open gastrostomy.