{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T22:03:01Z","timestamp":1790373781786,"version":"4.1.0"},"reference-count":158,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Main recommendations<\/jats:title>\n                  <jats:p>ESGE recommends the \u201cpull\u201d technique as the standard method for percutaneous endoscopic gastrostomy (PEG) placement.<\/jats:p>\n                  <jats:p>Strong recommendation, low quality evidence.<\/jats:p>\n                  <jats:p>ESGE recommends the direct percutaneous introducer (\u201cpush\u201d) technique for PEG placement in cases where the \u201cpull\u201d method is contraindicated, for example in severe esophageal stenosis or in patients with head and neck cancer (HNC) or esophageal cancer.<\/jats:p>\n                  <jats:p>Strong recommendation, low quality evidence.<\/jats:p>\n                  <jats:p>ESGE recommends the intravenous administration of a prophylactic single dose of a beta-lactam antibiotic (or appropriate alternative antibiotic, in the case of allergy) to decrease the risk of post-procedural wound infection.<\/jats:p>\n                  <jats:p>Strong recommendation, moderate quality evidence.<\/jats:p>\n                  <jats:p>ESGE recommends that inadvertent insertion of a nasogastric tube (NGT) into the respiratory tract should be considered a serious but avoidable adverse event (AE).<\/jats:p>\n                  <jats:p>Strong recommendation, low quality evidence.<\/jats:p>\n                  <jats:p>ESGE recommends that each institution should have a dedicated protocol to confirm correct positioning of NGTs placed \u201cblindly\u201d at the patient\u2019s bedside; this should include: radiography, pH testing of the aspirate, and end-tidal carbon dioxide monitoring, but not auscultation alone.<\/jats:p>\n                  <jats:p>Strong recommendation, low quality evidence.<\/jats:p>\n                  <jats:p>ESGE recommends confirmation of correct NGT placement by radiography in high-risk patients (intensive care unit [ICU] patients or those with altered consciousness or absent gag\/cough reflex).<\/jats:p>\n                  <jats:p>Strong recommendation, low quality evidence.<\/jats:p>\n                  <jats:p>ESGE recommends that EN may be started within 3\u200a\u2013\u200a4 hours after uncomplicated placement of a PEG or PEG-J.<\/jats:p>\n                  <jats:p>Strong recommendation, high quality evidence.<\/jats:p>\n                  <jats:p>ESGE recommends that daily tube mobilization (pushing inward) along with a loose position of the external PEG bumper (1\u200a\u2013\u200a2\u200acm from the abdominal wall) could mitigate the risk of development of buried bumper syndrome.<\/jats:p>\n                  <jats:p>Strong recommendation, low quality evidence.<\/jats:p>","DOI":"10.1055\/a-1331-8080","type":"journal-article","created":{"date-parts":[[2020,12,21]],"date-time":"2020-12-21T19:06:33Z","timestamp":1608577593000},"page":"178-195","source":"Crossref","is-referenced-by-count":92,"title":["Endoscopic management of enteral tubes in adult patients \u2013 Part 2: Peri- and post-procedural management. European Society of Gastrointestinal Endoscopy (ESGE) Guideline"],"prefix":"10.1055","volume":"53","author":[{"given":"Paraskevas","family":"Gkolfakis","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, CUB H\u00f4pital Erasme, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna","family":"Arvanitakis","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, CUB H\u00f4pital Erasme, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward J.","family":"Despott","sequence":"additional","affiliation":[{"name":"Royal Free Unit for Endoscopy and Centre for Gastroenterology, UCL Institute for Liver and Digestive Health, The Royal Free Hospital, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asuncion","family":"Ballarin","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, CUB H\u00f4pital Erasme, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3071-0428","authenticated-orcid":false,"given":"Torsten","family":"Beyna","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Therapeutic Endoscopy, Evangelisches Krankenhaus D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kurt","family":"Boeykens","sequence":"additional","affiliation":[{"name":"Nutrition Support Team, AZ Nikolaas Hospital, Moerlandstraat 1, 9100, Sint-Niklaas, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Elbe","sequence":"additional","affiliation":[{"name":"Department of Upper Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden"},{"name":"Division of Surgery, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid","family":"Gisbertz","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Bernhoven Hospital, Uden, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Hoyois","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, CUB H\u00f4pital Erasme, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ofelia","family":"Mosteanu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David S.","family":"Sanders","sequence":"additional","affiliation":[{"name":"Academic Unit of Gastroenterology, Royal Hallamshire Hospital & University of Sheffield, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter T.","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden"},{"name":"Department of Medicine, Ersta Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St\u00e9phane M.","family":"Schneider","sequence":"additional","affiliation":[{"name":"Universit\u00e9 C\u00f4te d\u2019Azur, Centre Hospitalier 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