This European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) position statement provides a comprehensive guide for health care providers to manage percutaneous endoscopic gastrostomy tubes in a safe, effective, and appropriate way. Relevant literature from searches of PubMed, CINAHL, and recent guidelines was reviewed. In the absence of evidence, recommendations reflect the expert opinion of the authors. Final consensus was obtained by multiple e-mail exchange and during 3 face-to-face meetings of the gastroenterology committee of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition. Endoscopically placed gastrostomy devices are essential in the management of children with feeding and nutritional problems. The article focuses on practical issues such as indications and contraindications. The decision to place an endoscopic gastrostomy has to be made by an appropriate multidisciplinary team, which then provides active follow-up and care for the child and the device.
Continuous enteral feeding: a major cause of pneumonia among ventilated intensive care unit patients
Percutaneous radiologic and endoscopic gastrostomy: a 3-year institutional analysis of procedure performance
Gastroesophageal reflux and Nissen fundoplication following percutaneous endoscopic gastrostomy in children
Enteral nutritional support by percutaneous endoscopic gastrostomy in children with congenital heart disease
Enteral feeding. Nasogastric, nasojejunal, percutaneous endoscopic gastrostomy, or jejunostomy: its indications and limitations
Persistence of gastrocutaneous fistula after removal of gastrostomy tubes in children: prevalence and associated factors
Long-term results with a new introducer method with gastropexy for percutaneous endoscopic gastrostomy
Percutaneous endoscopic gastrostomy in children: a safe technique with major symptom relief and high parental satisfaction
Balloon gastrostomy buttons in pediatric patients: evaluation with respect to size, lifetime in patients, and parent acceptance
New introducer PEG gastropexy does not require prophylactic antibiotics: multicenter prospective randomized double-blind placebo-controlled study
Clinical manifestations and management of buried bumper syndrome in patients with percutaneous endoscopic gastrostomy
Prospective randomized trial comparing the direct method using a 24 Fr bumper-button-type device with the pull method for percutaneous endoscopic gastrostomy
Assessment of safety and feasibility of a new technical variant of gastropexy for percutaneous endoscopic gastrostomy: an experience with 435 cases.
The effect of gastrostomy tube feeding on body protein and bone mineralization in children with quadriplegic cerebral palsy
Withdrawing feeds from children on long term enteral feeding: factors associated with success and failure
Influence of percutaneous endoscopic gastrostomy on gastro-oesophageal reflux evaluated by multiple intraluminal impedance in children with neurological impairment
Clinical Guidelines For the Use of Parenteral and Enteral Nutrition in Adult and Pediatric Patients: applying the GRADE system to development of A.S.P.E.N. clinical guidelines
Nutritional rehabilitation increases the resting energy expenditure of malnourished children with severe cerebral palsy
Percutaneous endoscopic gastrostomy as a method of nutrition support in children with chronic kidney disease
The relationship between percutaneous endoscopic gastrostomy and gastro-oesophageal reflux disease in children: a systematic review.
Gastrostomy insertion in the 21st century: PEG or laparoscopic? Report from a large single-centre series.
Percutaneous Endoscopic Gastrostomy: A Practical Overview on Its Indications, Placement Conditions, Management, and Nursing Care
Antibiotic prophylaxis does not reduce the infection rate following percutaneous endoscopic gastrostomy in infants and children
Paediatric Gastrointestinal Endoscopy: European Society for Paediatric Gastroenterology Hepatology and Nutrition and European Society of Gastrointestinal Endoscopy Guidelines
Gastrostomy Tube Feeding in Children With Developmental or Acquired Disorders: A Longitudinal Comparison on Healthcare Provision and Eating Outcomes 4 Years After Gastrostomy
Documentation of everyday life and health care following gastrostomy tube placement in children: a content analysis of medical records.
Comparison of Tolerance and Complication Rates Between Early and Delayed Feeding After Percutaneous Endoscopic Gastrostomy Placement in Children.
Quality Improvement Initiative: The Administration of Early Nutrition Following Percutaneous Endoscopic Gastrostomy Tube Placement in Children.
The Use of Jejunal Tube Feeding in Children: A Position Paper by the Gastroenterology and Nutrition Committees of the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition 2019
Outcomes Associated With Early vs Late Initiation of Exclusive Enteral Feeding Regimens Following Laparoscopic Gastrostomy Tube Placement in the Pediatric Patient.
Gastrostomy tube insertion in children with developmental or acquired disorders: a register-based study
Delivery of a nutritional prescription by enteral tube feeding in children with chronic kidney disease stages 2-5 and on dialysis-clinical practice recommendations from the Pediatric Renal Nutrition Taskforce.
The protocol for a randomised-controlled trial of the evaluation of the tolerance and safety of early enteral nutrition in children after percutaneous endoscopic gastrostomy placement. (protocol version 09.01.2015)
Gastrostomy Tube Insertion in Pediatric Patients With Autosomal Recessive Polycystic Kidney Disease (ARPKD): Current Practice
Do Antibiotics Reduce the Incidence of Infections After Percutaneous Endoscopic Gastrostomy Placement in Children?
Top-ten tips for managing nutritional issues and gastrointestinal symptoms in children with neurological impairment.
Factors Associated With Success and Failure of Weaning Children From Prolonged Enteral Nutrition: A Retrospective Cohort Study.
Antibiotic Prophylaxis for Percutaneous Endoscopic Gastrostomy in Children: A Randomised Controlled Trial.
Pediatric Buried Bumper Syndrome: Diagnostic Validity of Transabdominal Ultrasound and Artificial Intelligence.
Analysis of frequency and risk factors for complications of enteral nutrition in children in Poland after percutaneous endoscopic gastrostomy placement.
Laparoscopic-Assisted Percutaneous Endoscopic Gastrostomy Reduces Major Complications in High-Risk Pediatric Patients.
Knowledge Levels and Practices About the Enteral Nutritional Practices of Informal Caregivers Caring for Patients Fed Through a Percutaneous Endoscopic Gastrostomy Tube: A Descriptive Observational Study.
Temporary feeding tube dependency in pediatric patients: A retrospective analysis of risk factors and preventative practices.
Feasibility of percutaneous endoscopic gastrostomy insertion in children receiving peritoneal dialysis.
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