Percutaneous endoscopic gastrostomy complications and management

Percutaneous endoscopic gastrostomy (PEG) is a minimally invasive method that does not require surgery for patients requiring long-term enteral feeding. It is especially used in neurological diseases, post-cancer dysphagia and intensive care patients. It has lower complication rates compared to surgical gastrostomy, but carries risks such as infection, bleeding, fistula formation, tube obstruction and dislocation. Careful patient selection, sterile techniques and regular care are essential to prevent complications. Pre-procedure antibiotic prophylaxis, coagulopathy assessment and appropriate tube placement techniques reduce risks. Infection control, tube care protocols and nutritional management increase the effectiveness of PEG. Late complications include peristomal leakage, granuloma formation, tube obstruction and buried bumper syndrome. Regular cleaning, tube rotation and appropriate nutritional strategies should be applied to prevent these. New technologies play an important role in increasing PEG safety. Antibacterial coated tubes, magnetic guidance systems and endoscopic ultrasound-assisted techniques are promising in reducing complications. Multidisciplinary nutrition teams managing the process can improve patient prognosis and increase quality of life.