ESPEN-经皮内镜胃造瘘肠内营养指南(英文)(pdf 18页)

Introduction
Since the first published report of a percutaneous
endoscopic gastrostomy (PEG) in 1980 by Gauderer
and Ponsky,1 the procedure has been modified and
improved several times. It has now replaced the
surgical gastrostomy (Witzel gastrostomy, Stamm
gastrostomy, Janeway gastrostomy) which was
associated with a markedly higher rate of complications.
2,3 Placement of a PEG/PEJ (percutaneous
endoscopic jejunostomy) tube is simple, safe and
well-tolerated by patients.4,5 There is a wide range
of diets and nutrient preparations suitable for tube
feeding currently available. Modern PEG tube
systems made of polyurethane or silicone rubber
are easy to insert and well-tolerated. Clinicians
have a broad spectrum of low risk, practicable,
patient-orientated forms of enteral nutritional
therapy available. PEG-feeding, therefore, has
rapidly spread to become routine practice worldwide
and is currently the method of choice for
medium- and long- term enteral feeding.
Recent studies have provided new information on
the benefits and drawbacks of PEG-feeding. We
have a clearer appreciation of ethical issues
surrounding artificial enteral feeding. Since we
started placing percutaneous enteral tube systems
by endoscopic techniques nearly 25 years ago1 our
attitude towards this method has changed in many
ways: in the early days PEG-tubes were often used
in patients in the advanced state of predominantl
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