Percutaneous Endoscopic Gastrostomy (PEG): Techniques, Effectiveness and Potential Complications

$230.00

Eric M. Pauli, MD (Editor)
Department of Surgery, Penn State Hershey Medical Center, Hershey, PA, USA

Jeffrey M. Marks (Editor)
University Hospitals Case Medical Center, Cleveland, OH, USA

Series: Surgery – Procedures, Complications, and Results
BISAC: TEC010020

Percutaneous endoscopic gastrostomy (PEG) tubes are placed more than 125,000 times a year in the Unites States alone, making it one of the most common therapeutic endoscopic procedures. The editor, Eric Mark Pauli, along with his co-editor Dr. Jeffrey Marks had the good fortune of training with Dr. Jeffrey Ponsky, the recognized co-developer of the technique.

PEG is deceptively simple. You do not need to complete a fellowship to understand it. In the majority of patients, PEG is a 10 minute procedure that requires minimal pre-operative evaluation, a moderate amount of surgical/endoscopic skill and minimal post-operative follow up. The trick to being good at PEG lies in recognizing those circumstances that require more forethought, more patient/family discussion, more endoscopic skills, more post-operative management. If such recognition is followed up with appropriate action, few patients should be deemed “un-PEGable” and complications should be kept to an absolute minimum.

The purpose of this book is twofold. First, for the individual who is new to performing PEG, it provides an overview of the basic management strategies and endoscopic techniques as they are performed by recognized experts in their respective fields. Second, for the practitioner who already performs PEG, the editor hope that it exposes them to alternative techniques and more advanced therapeutic options such that they can offer the procedure to more patients in an even safer fashion. (Imprint: Nova Biomedical)

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Table of Contents

Dedication

Introduction. Hello, Is This The PEG Fellow?
Eric M. Pauli (Assistant Professor of Surgery, Director of Endoscopic Surgery, Department of Surgery, Penn State Hershey Medical Center, Hershey, PA, USA)

Chapter 1. Percutaneous Endoscopic Gastrostomy: An Historical Perspective
Jeffrey L. Ponsky (Professor of Surgery, Department of Surgery, The Cleveland Clinic, Cleveland, OH, USA)

Chapter 2. Indications, Contraindications, Decision Making and Informed Consent
Robert D. Fanelli and Josephine A. Fanelli (The Guthrie Clinic, PC, Sayre, PA, USA)

Chapter 3. Palliative Considerations of Gastrostomy
Julie L. Mitchell and Susan A. Glod (Department of Medicine, Penn State Hershey Medical Center, Hershey, PA, USA)

Chapter 4. Preoperative Management
Valerie Wu Chao Ying and Jose M. Martinez (Department of Surgery, University of Miami, Miller School of Medicine, Miami, FL, USA)

Chapter 5. Anesthesia for PEG Tube Placement
S. William Hazard (Assistant Professor of Anesthesiology, Director, Neuroanesthesia, Department of Anesthesiology, Penn State Hershey Medical Center, Hershey, PA, USA)

Chapter 6. Diagnostic Endoscopy During PEG
Susan M. Wetzel, Mei Chris Huang and John D. Mellinger (Department of Surgery, Southern Illinois University School of Medicine, Springfield, IL, USA)

Chapter 7. Percutaneous Endoscopic Gastrostomy: The ‘Pull’ Technique
Kyle L. Kleppe and Melissa Phillips LaPinska (Department of Surgery, University of Tennessee School of Medicine, Knoxville, TN, USA)

Chapter 8. Percutaneous Endoscopic Gastrostomy: The ‘Push’ Technique
Keyur Parikh and Richard C. K. Wong (Department of Medicine, University Hospitals Case Medical Center, Cleveland, OH, USA)

Chapter 9. Percutaneous Endoscopic Gastrostomy: Introducer Technique
Sean B. Orenstein (Assistant Professor of Surgery, Division of Gastrointestinal and General Surgery, Department of Surgery, Oregon Health & Science University, Portland, OR, USA)

Chapter 10. Direct Percutaneous Endoscopic Jejunostomy
Mena Boules, Andrew Strong and Matthew Kroh (Department of General Surgery, Cleveland Clinic, Cleveland, OH, USA)

Chapter 11. PEG with Jejunal Extension Tube
Ryan R. Gaffney and Matthew T. Moyer (Division of Gastroenterology-Hepatology, Department of Medicine, Penn State Hershey Medical Center, Hershey, PA, USA)

Chapter 12. Alternative Gastric Access Methods: SLiC and PTEG
Adrian B. Dobrowolsky and Bipan Chand (Loyola University Medical Center, Marywood, IL, USA)

Chapter 13. ‘Assisted’ PEG Placement
Salvatore Docimo, Jr. and Eric M. Pauli (Department of Surgery, Penn State Hershey Medical Center, Hershey, PA, USA)

Chapter 14. PEG and PEJ in the Post-Bariatric Surgery Patient
Ryan M. Juza and Ann M. Rogers (Department of Surgery, Penn State Hershey Medical Center, Hershey, PA, USA)

Chapter 15. Alternative Uses of Percutaneous Endoscopic Gastrostomy
Heidi J. Miller and Jeffrey M. Marks (Department of Surgery, University Hospitals Case Medical Center, Cleveland, OH, USA)

Chapter 16. Postoperative Management
Fazia A. Mir, Douglas L. Nguyen and Matthew L. Bechtold (Division of Gastroenterology, Department of Medicine, University of Missouri, Columbia, MO, USA, and others)

Chapter 17. Prevention of Peristomal PEG Infection
Iruru Maetani (Professor of Medicine, Chairman, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan)

Chapter 18. Acute Complications of PEG
Lava Y. Patel and Michael B. Ujiki (Department of Surgery, NorthShore University HealthSystem, Evanston, IL, USA)

Chapter 19. Chronic Complications of PEG
Faris M. Murad and Jeffrey A. Blatnik (Department of Surgery, Washington University School of Medicine, St Louis, MO, USA, and others)

Chapter 20. Endoscopic Management of PEG Related Complications
Joshua S. Winder and Eric M. Pauli (Department of Surgery, Penn State Hershey Medical Center, Hershey, PA, USA)

Index


Reviews

“I am honored to have had the privilege of reviewing “Percutaneous Endoscopic Gastrostomy” (PEG) edited by doctors Pauli and Marks.” I have lived every day of almost the past four decades dealing with the issues of PEG, its indications, methods, and complications. During that time I have seen little dramatic change in the initial methods, but rather a subtle evolution in the selection of patients, and refinement of technique. I have been blessed to work with a number of caring and talented physicians who have supported me and made significant contributions to my efforts. Many of those individuals are authors herein. The present work is well designed, comprehensive, and well written. The issues surrounding patient selection, ethics, technique, and complications are addressed and the illustrations and photographs are excellent, demonstrating even minor details clearly. The editorial comments at the end of each chapter serve to focus the reader upon the important issues addressed. This is the most comprehensive treatise ever written on this subject and an important addition to the library of every therapeutic endoscopist.” – Jeffrey L. Ponsky, M.D., Professor of Surgery, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio.

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