Clinical Endoscopy

Review

Clinical practice guidelines for percutaneous endoscopic gastrostomy: Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee, Korean Society of Gastrointestinal Endoscopy Task Force on Clinical Practice Guidelines; Clin Endosc 2023;56(4):391-408. Published online June 23, 2023; DOI: https://doi.org/10.5946/ce.2023.062

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With an aging population, the number of patients with difficulty in swallowing due to medical conditions is gradually increasing. In such cases, enteral nutrition is administered through a temporary nasogastric tube. However, the long-term use of a nasogastric tube leads to various complications and a decreased quality of life. Percutaneous endoscopic gastrostomy (PEG) is the percutaneous placement of a tube into the stomach that is aided endoscopically and may be an alternative to a nasogastric tube when enteral nutritional is required for four weeks or more. This paper is the first Korean clinical guideline for PEG developed jointly by the Korean College of Helicobacter and Upper Gastrointestinal Research and led by the Korean Society of Gastrointestinal Endoscopy. These guidelines aimed to provide physicians, including endoscopists, with the indications, use of prophylactic antibiotics, timing of enteric nutrition, tube placement methods, complications, replacement, and tube removal for PEG based on the currently available clinical evidence.

Citations

Citations to this article as recorded by

A Case of Perforated Peritonitis Caused by the Migration of a Single‐Puncture Gastric Wall Fixation Device Following Percutaneous Endoscopic Gastrostomy
Yuu Kodama, Yuji Mizokami, Hidemitsu Nishizawa, Gen Maeda, Gen Kimura, Yuzo Toyama, Shingo Asahara, Ryuji Nagahama, Hideki Sunagawa
DEN Open.2026;[Epub] CrossRef
A systematic review and quality appraisal of guidelines and recommendations for home enteral tube feeding in adults
Andriana Korai, Isabella Thomson, Sharon Carey, Margaret Allman-Farinelli
European Journal of Clinical Nutrition.2025; 79(2): 104. CrossRef
One-Year Mortality After Percutaneous Endoscopic Gastrostomy: The Prognostic Role of Nutritional Biomarkers and Care Settings
Nermin Mutlu Bilgiç, Güldan Kahveci, Ekmel Burak Özşenel, Sema Basat
Nutrients.2025; 17(5): 904. CrossRef
Malnutrition and perioperative nutritional rehabilitation in major operations
Konstantinos Lasithiotakis, Alexandros Andreou, Hammam Migdadi, Evangelos I. Kritsotakis
European Surgery.2025;[Epub] CrossRef
Endoscopic gastrostomy as a method of enteral nutrition providing
E. A. Drobyazgin, Yu. V. Chikinev, A. V. Korobeynikov, A. S. Polyakevich, I. V. Peshkova, S. G. Stofin
Filin’s Clinical endoscopy.2025; 67(1): 54. CrossRef
Clinical Advances in Percutaneous Endoscopic Gastrostomy: A 2023 Clinical Practice Guideline-Based Review
Ji Yong Ahn
The Korean Journal of Medicine.2025; 100(2): 54. CrossRef
Timing of Gastrostomy Relative to Tracheostomy After Complete Cervical Spinal Cord Injury: Impact on Hospitalization Outcomes and Complication Rates
Ahmad Essa, Armaan K. Malhotra, Husain Shakil, Avery B. Nathens, Eva Y. Yuan, Yingshi He, Francois Mathieu, Michael C. Sklar, Jefferson R. Wilson, Christopher D. Witiw, Jetan H. Badhiwala
Neurosurgery.2025;[Epub] CrossRef
Outcomes of early compared with delayed initiation of feeding after placement of percutaneous endoscopic gastrostomy tube: A systematic review and meta‐analysis
Mudathir Ibrahim, Ceilidh McKenney, Camilla Sophia Rossi, Susan Khader Ibrahim, Ahmed Alnajar, Gianmarco Cancelli, Matthew McKenney, Michelle Demetres, Zi Yuan, Jeffrey Nicastro, Joel Horovitz
Journal of Parenteral and Enteral Nutrition.2025;[Epub] CrossRef
Predictors of failure of percutaneous endoscopic gastrostomy tube placement: a retrospective study in a tertiary care center in the USA
Ryan Xin, Cassandra Sanossian, Melissa Fazzari, Brandon Mui, Marouf Hossain, Jennifer Katz
Clinical Endoscopy.2025; 58(3): 418. CrossRef
A Multicenter Survey of Percutaneous Endoscopic Gastrostomy in 2019 at Korean Medical Institutions
Jun Woo Park, Tae Gyun Kim, Kwang Bum Cho, Jeong Seok Kim, Jin Woong Cho, Jung Won Jeon, Sun Gyo Lim, Chan Gyoo Kim, Hong Jun Park, Tae Jun Kim, Eun Sun Kim, Su Jin Jeong, Yong Hwan Kwon
Gut and Liver.2024; 18(1): 77. CrossRef
Fast-track discharge following percutaneous endoscopic gastrostomy removal in head and neck cancer patients after remission: a feasibility and safety study
Daniel Conceição, Luís Correia Gomes, Fátima Francisco, Ivone Frade, Joana Gramacho, Sandra Faias, Isabel Claro
Journal of Gastrointestinal Surgery.2024; 28(6): 943. CrossRef
When to feed after percutaneous endoscopic gastrostomy: A systematic review and meta‐analysis of randomized controlled trials
Matthew L. Bechtold, Zahid Ijaz Tarar, Muhammad N. Yousaf, Ghady Moafa, Abdul M. Majzoub, Xheni Deda, Michelle L. Matteson‐Kome, Srinivas R. Puli
Nutrition in Clinical Practice.2024; 39(5): 1191. CrossRef
The Effect of Oral Diet Training in Indwelling Nasogastric Tube Patients with Prolonged Dysphagia
Byung-chan Choi, Sook Joung Lee, Eunseok Choi, Sangjee Lee, Jungsoo Lee
Nutrients.2024; 16(15): 2424. CrossRef
The Impact of Palliative Decompressive Gastrostomy Tube Placement on Patients and Their Caregivers: A Mixed Methods Analysis
Jeffrey L. Roberson, Julia A. Gasior, Sara P. Ginzberg, Emna Bakillah, Jesse Passman, Lauren Shreve, Catherine E. Sharoky, Gregory Nadolski, Katherine R. Courtright, Elinore J. Kaufman
Annals of Surgical Oncology.2024; 31(10): 6931. CrossRef

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Commentary

Endoscopic Endoluminal Vacuum Therapy or Self-Expandable Metallic Stent: Treatment Option in Anastomotic Leakage after Esophageal Surgery: Chul-Hyun Lim; Clin Endosc 2022;55(1):41-42. Published online January 27, 2022; DOI: https://doi.org/10.5946/ce.2022.011

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Citations

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Endoscopic vacuum therapy for gastrointestinal transmural defects: a literature review
Tan Minh Le, Van Huy Tran, Kyu Sung Chung, Seong Woo Jeon
Clinical Endoscopy.2025; 58(2): 181. CrossRef

2,876 View
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Original Articles

Bleeding after Endoscopic Resection in Patients with End-Stage Renal Disease on Dialysis: A Multicenter Propensity Score-Matched Analysis: In Kyung Yoo, Chan Gyoo Kim, Young Ju Suh, Younkyung Oh, Gwang Ho Baik, Sun Moon Kim, Young Dae Kim, Chul-Hyun Lim, Jung Won Jeon, Su Jin Hong, Byoung Wook Bang, Joon Sung Kim, Jun-Won Chung; Clin Endosc 2020;53(4):452-457. Published online October 25, 2019; DOI: https://doi.org/10.5946/ce.2019.107

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Background
/Aims: Frequent bleeding after endoscopic resection (ER) has been reported in patients with end-stage renal disease (ESRD). We aimed to evaluate the association and clinical significance of bleeding with ER in ESRD patients on dialysis.
Methods
Between February 2008 and December 2018, 7,571 patients, including 47 ESRD patients on dialysis who underwent ER for gastric neoplasia, were enrolled. A total of 47 ESRDpatients on dialysis were propensity score-matched 1:10 to 470 non-ESRD patients, to adjust for between-group differences in variables such as age, sex, comorbidities, anticoagulation use, tumor characteristics, and ER method. Matching was performed using an optimal matching algorithm. For the matched data, clustered comparisons were performed using the generalized estimating equation method. Medical records were retrospectively reviewed. Frequency and outcomes of post-ER bleeding were evaluated.
Results
Bleeding was more frequent in the ESRD with dialysis group than in the non-ESRD group. ESRD with dialysis conferred a significant risk of post-ER bleeding (odds ratio, 6.1; 95% confidence interval, 2.7–13.6; p<0.0001). All post-ER bleeding events were controlled using endoscopic hemostasis except in 1 non-ESRD case that needed surgery.
Conclusions
ESRD with dialysis confers a bleeding risk after ER. However, all bleeding events could be managed endoscopically without sequelae. Concern about bleeding should not stop endoscopists from performing ER in ESRD patients on dialysis.

Citations

Citations to this article as recorded by

Chronic Kidney Disease Increases Risk of Delayed Post‐Polypectomy Bleeding: A Large‐Scale Propensity Score‐Matched Analysis
Hye Kyung Hyun, Nak‐Hoon Son, So Hyeon Gwon, Hyun Chul Lim, Jihye Park, Soo Jung Park, Jae Jun Park, Jae Hee Cheon, Tae Il Kim, Tae‐Hyun Yoo, Shin‐Wook Kang, Hae‐Ryong Yun, Cheal Wung Huh
United European Gastroenterology Journal.2025;[Epub] CrossRef
Prediction and prevention of post-procedural bleedings in patients with cirrhosis
Alix Riescher-Tuczkiewicz, Pierre-Emmanuel Rautou
Clinical and Molecular Hepatology.2025; 31(Suppl): S205. CrossRef
Risk of Post-polypectomy Bleeding After Colorectal Endoscopic Mucosal Resection in Patients with Chronic Kidney Disease: A Propensity-Matched Analysis of the US Collaborative Network
Azizullah Beran, Khaled Elfert, Feenalie N. Patel, Mouhand Mohamed, Daryl Ramai, Almaza Albakri, Nasir Saleem, Faisal Kamal, Andrew Canakis, Khaled Srour, Danial H. Shaikh, Shyam Thakkar, Douglas K. Rex, Indira Bhavsar-Burke, John J. Guardiola
Digestive Diseases and Sciences.2025;[Epub] CrossRef
The Outcomes of Colorectal Endoscopic Submucosal Dissection in Patients with Chronic Kidney Disease: A Honam Association for the Study of Intestinal Disease (HASID) Multicenter Study
Byung Chul Jin, Dong Hyun Kim, Geom-Seog Seo, Sang-Wook Kim, Hyung-Hoon Oh, Hyo-Yeop Song, Seong-Jung Kim, Young-Eun Joo, Jun Lee, Hyun-Soo Kim
Diagnostics.2024; 14(13): 1459. CrossRef
Characteristics of factors contributing to follow-up for suspected delayed bleeding after colorectal endoscopic submucosal dissection
Satsuki Takahashi, Kenichiro Okimoto, Tomoaki Matsumura, Yuhei Oyama, Hayato Nakazawa, Yukiyo Mamiya, Chihiro Goto, Ryosuke Horio, Akane Kurosugi, Michiko Sonoda, Tatsuya Kaneko, Naoki Akizue, Yuki Ohta, Takashi Taida, Keiko Saito, Jun Kato, Naoya Kato
Gastrointestinal Endoscopy.2024; 100(4): 718. CrossRef
Effect of renal insufficiency on the short‐ and long‐term outcomes of endoscopic submucosal dissection for early gastric cancer: Propensity score‐matched analysis
Tae‐Se Kim, Byung‐Hoon Min, Sun‐Young Baek, Kyunga Kim, Yang Won Min, Hyuk Lee, Poong‐Lyul Rhee, Jae J. Kim, Jun Haeng Lee
Digestive Endoscopy.2023; 35(7): 869. CrossRef
Safeness of Endoscopic Resection in Patients with End-Stage Renal Disease on Dialysis
Sun-Jin Boo
Clinical Endoscopy.2020; 53(4): 381. CrossRef

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Factors Affecting Endoscopic Curative Resection of Gastric Cancer in the Population-Based Screening Era: Yoon Gwon Mun, Myung-Gyu Choi, Chul-Hyun Lim, Han Hee Lee, Dong Hoon Kang, Jae Myung Park, Kyo Young Song; Clin Endosc 2018;51(5):478-484. Published online June 1, 2018; DOI: https://doi.org/10.5946/ce.2018.006

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Background
/Aims: Since population-based screening for gastric cancer in Korea was implemented, endoscopic treatment of early gastric cancer has become increasingly popular. This study investigates factors affecting endoscopic curative resection of early gastric cancer in population-based screening for gastric cancer.
Methods
We retrospectively reviewed data of patients with newly diagnosed gastric cancer who underwent treatment at Seoul St. Mary’s Hospital. All patients completed questionnaires about clinical information, including interval between surveillance tests for gastric cancer.
Results
Of 469 gastric cancer patients, 147 (31.3%) had undergone curative endoscopic resection, 260 (55.4%) had undergone curative surgical resection, and 62 (13.3%) underwent non-curative resection or were in an inoperable state. Patients with curative endoscopic resection had fewer alarm symptoms/signs than other groups. In multivariate analysis, regular surveillance endoscopy was the only factor predicting curative endoscopic resection (odds ratio [OR], 6.099; 95% confidence interval [CI], 2.532–14.933). In addition, patients undergoing gastric cancer screening had a significantly higher rate of endoscopic curative resection compared with subjects who had never been screened. (1-year interval: OR, 49.969; 95% CI, 6.340–393.827, 2-year interval: OR, 15.283; 95% CI, 1.833–127.406, over 2-year interval: OR, 10.651; 95% CI, 1.248–90.871). Shorter screening test intervals were associated with higher rates of endoscopic curative resection.
Conclusions
Regular surveillance testing was the independent factor predicting curative endoscopic resection of gastric cancer.

Citations

Citations to this article as recorded by

A model established using marital status and other factors from the Surveillance, Epidemiology, and End Results database for early stage gastric cancer
Lixiang Zhang, Baichuan Zhou, Panquan Luo, Aman Xu, Wenxiu Han, Zhijian Wei
Journal of Investigative Medicine.2022; 70(6): 1373. CrossRef
Risk Factors and Clinical Outcomes of Non-Curative Resection in Patients with Early Gastric Cancer Treated with Endoscopic Submucosal Dissection: A Retrospective Multicenter Study in Korea
Si Hyung Lee, Min Cheol Kim, Seong Woo Jeon, Kang Nyeong Lee, Jong Jae Park, Su Jin Hong
Clinical Endoscopy.2020; 53(2): 196. CrossRef
The More, the Better: Is This True in Endoscopy for Gastric Cancer Screening?
Seong Woo Jeon
Clinical Endoscopy.2018; 51(5): 402. CrossRef

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Performance and Cost of Disposable Biopsy Forceps in Upper Gastrointestinal Endoscopy: Comparison with Reusable Biopsy Forceps: Chul-Hyun Lim, Myung-Gyu Choi, Won Chul Kim, Jin Soo Kim, Yu Kyung Cho, Jae Myung Park, In Seok Lee, Sang Woo Kim, Kyu Yong Choi, In-Sik Chung; Clin Endosc 2012;45(1):62-66. Published online March 31, 2012; DOI: https://doi.org/10.5946/ce.2012.45.1.62

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Background/Aims

It is believed that disposable biopsy forceps are more costly than reusable biopsy forceps. In this study, we evaluated performance and cost of disposable forceps versus reusable forceps in esophagogastroduodenoscopic biopsy.

Methods

Between October 2009 and July 2010, we enrolled 200 patients undergoing esophagogastroduodenoscopic biopsy at Seoul St. Mary's Hospital. Biopsies were performed with 100 disposable or 5 reusable forceps by random assignment. Seventy-five additional patients were studied to estimate durability of reusable forceps. The assisting nurses estimated the performance of the forceps. The evaluation of costs included purchase prices and reprocessing costs. The adequacy of the sample was estimated according to the diameter of the obtained tissue.

Results

Performance of disposable forceps was estimated as excellent in 97.0%, good in 2.0% and adequate in 1.0%. Reusable forceps were estimated as excellent in 36.0%, good in 36.0%, adequate in 25.1% and inadequate in 2.9%. The performance of reusable forceps declined with the number of uses. The reprocessing cost of reusable forceps for one biopsy session was calculated as ₩8,021. The adequacy of the sample was excellent for both forceps.

Conclusions

Disposable forceps showed excellent performance. Considering the reprocessing costs of reusable forceps, usage of disposable forceps with a low price should be considered.

Citations

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Multisociety guidance for sterilization and high-level disinfection
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Infection Control & Hospital Epidemiology.2025; : 1. CrossRef
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Mandana Zanganeh, Yufei Jiang, Anna Brown, Yen-Fu Chen, Ramesh P Arasaradnam, Lazaros Andronis
BMJ Open Gastroenterology.2025; 12(1): e001712. CrossRef
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Alessandro Repici, Kareem Khalaf, Edoardo Troncone, Sharmila Subramaniam, Cesare Hassan, Pradeep Bhandari, Lars AABAKKEN, Sarah ABERE, Maisam W. AKROUSH, Abed AL-LEHIBI, Eduardo ALBÉNIZ, Asma ALKANDARI, Majid A. ALMADI, Andrea ANDERLONI, Amol BAPAYE, Napo
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Single‐use accessories and endoscopes in the era of sustainability and climate change—A balancing act
Zaheer Nabi, Raymond S. Y. Tang, Sridhar Sundaram, Sundeep Lakhtakia, D. Nageshwar Reddy
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Ressourcenschonung aus Sicht der Hygiene
Susanne Kolbe-Busch, Iris F. Chaberny
Die Chirurgie.2023; 94(3): 220. CrossRef
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Jonathan Lans, Ritsaart F. Westenberg, Svenna H.W.L. Verhiel, Rohit Garg, Jesse B. Jupiter, Neal C. Chen
Journal of Orthopaedic Trauma.2021; 35(9): e346. CrossRef
Multidisciplinary and Multisociety Practice Guideline on Reprocessing Flexible Gastrointestinal Endoscopes and Endoscopic Accessories
Dae Young Cheung, Byung Ik Jang, Sang Wook Kim, Jie-Hyun Kim, Hyung Keun Kim, Jeong Eun Shin, Won Jae Yoon, Yong Kang Lee, Kwang Hyun Chung, Soo-Jeong Cho, Hyun Phil Shin, Sun Young Cho, Woon Geon Shin, Kee Don Choi, Byung-Wook Kim, Joong Goo Kwon, Hee Ch
Clinical Endoscopy.2020; 53(3): 276. CrossRef
Multidisciplinary and Multisociety Practice Guidelines for Reprocessing Flexible Gastrointestinal Endoscopes and Endoscopic Accessories; Korean Association for the Study of the Liver, the Korean Society of Infectious Diseases, Korean College of Helicobact
Dae Young Cheung, Byung Ik Jang, Sang Wook Kim, Jie-Hyun Kim, Hyung Keun Kim, Jeong Eun Shin, Won Jae Yoon, Yong Kang Lee, Kwang Hyun Chung, Soo-Jeong Cho, Hyun Phil Shin, Sun Young Cho, Woon Geon Shin, Kee Don Choi, Byung-Wook Kim, Joong Goo Kwon, Hee Ch
The Korean Journal of Medicine.2020; 95(5): 325. CrossRef
Korean Society of Gastrointestinal Endoscopy Guidelines for Endoscope Reprocessing
Byoung Kwan Son, Byung-Wook Kim, Won Hee Kim, Dae-Sung Myung, Young-Seok Cho, Byung Ik Jang
Clinical Endoscopy.2017; 50(2): 143. CrossRef
Korean Society of Gastrointestinal Endoscopy (KSGE) Guidelines for Endoscope Reprocessing
Byung-Wook Kim, Byoung Kwan Son, Won Hee Kim, Dae-Sung Myung, Young-Seok Cho, Byung Ik Jang
The Korean Journal of Medicine.2017; 92(3): 239. CrossRef
Evaluating Quality and Adequacy of Gastrointestinal Samples Collected using Reusable or Disposable Forceps
J.A. Cartwright, T.L. Hill, S. Smith, D. Shaw
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Tomáš Andrašina, Jiří Pánek, Tomáš Rohan, Petra Kovalčíková, Tomáš Grolich, Lenka Ostrížková, Vlastimil Válek
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Ji Kon Ryu, Eun Young Kim, Kwang An Kwon, Il Ju Choi, Ki Baik Hahm
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King-Wah Chiu
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GS Devadiga, VMP Thomas, S Shetty, MS Setia
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