American Society for Gastrointestinal Endoscopy Guideline on Gastrostomy Feeding Tubes: Methodology and Review of Evidence

Authors

Divyanshoo Rai Kohli
Natalie Cosgrove
Wasif M Abidi
Jorge D Machicado
Madhav Desai
Nauzer Forbes
Neil B Marya
Nikhil R Thiruvengadam
Nirav C Thosani
Omeed Alipour
Saowanee Ngamruengphong
Sherif E Elhanafi
Sunil G Sheth
Wenly Ruan
John C Fang
Stephen A McClave
Rodrick C Zvavanjanja
Dhruvil K Radadiya
Amir Y Kamel
Bashar J Qumseya

Language

English

Publication Date

1-1-2025

Journal

VideoGIE

DOI

10.1016/j.vgie.2024.09.014

PMID

39925405

PMCID

PMC11806427

PubMedCentral® Posted Date

11-28-2024

PubMedCentral® Full Text Version

Post-print

Abstract

This article from the American Society for Gastrointestinal Endoscopy (ASGE) provides a full description of the methodology used to inform the final guidance outlined in the accompanying summary and recommendations article for strategies to manage endoscopically placed gastrostomy tubes. This article was developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework and specifically addresses the utility of PEG versus interventional radiology-guided gastrostomy (IR-G), the need for withholding antiplatelet and anticoagulant medications, appropriate timing to initiate tube feedings, and appropriate selection of the gastrostomy technique in patients with malignant dysphagia. In patients needing enteral access, the ASGE suggests PEG as the preferred technique for initial gastrostomy over IR-G. The ASGE recommends that tube feeding can be safely started within 4 hours of the gastrostomy without the need for an intentional delay. The ASGE suggests that a PEG can be performed without the need to withhold antiplatelet medications. In patients on anticoagulants who need to undergo PEG placement, the ASGE suggests that the periprocedural management of anticoagulants should be based on a multidisciplinary discussion with the patient regarding the risk of bleeding versus cardiovascular adverse events. In patients with malignant dysphagia, either transoral "Pull" PEG or transcutaneous "Direct" PEG can be performed for initial enteral access.

Published Open-Access

yes

Recommended Citation

Kohli, Divyanshoo Rai; Cosgrove, Natalie; Abidi, Wasif M; et al., "American Society for Gastrointestinal Endoscopy Guideline on Gastrostomy Feeding Tubes: Methodology and Review of Evidence" (2025). Faculty, Staff and Student Publications. 2171.
https://digitalcommons.library.tmc.edu/uthmed_docs/2171