Percutaneous Endoscopic Gastrostomy: Preferred Mode of Mid- and Long-Term Enteral Access Yet Underutilized in India

Percutaneous endoscopic gastrostomy (PEG) is the preferred mode for establishing long-term enteral feeding worldwide. This review provides an overview of current indications, contraindications, techniques, complications, and postprocedure care related to PEG placement, with an emphasis on Indian practice. Post-PEG placement management and care by relatives/caretakers with PEG removal methods are also emphasized in the article. Though PEG placement is associated with minor or even major complications, the majority of patients do well if we follow standard practices as mentioned in the article. Informal estimates from selected tertiary centers and industry sources suggest that PEG utilization in India may be significantly lower than expected; however, the lack of a national registry limits precise measurement. Factors accounting for this are lack of awareness and acceptance by patients/relatives, lack of counseling from treating physician/surgeon, cost involved and even unawareness, and poor acceptance in the doctor community due to prevalent misconceptions.