Gastrostomy Tube Replacement

Gastrostomy Tube Replacement

Credits: 1.00   Post-Assessment Questions:  4

Release Date: 5 Oct 2020
Expiration Date: 5 May 2021
Last Reviewed: 5 May 2020
Estimated Time To Finish: 60 Minutes

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Activity Description

A gastrostomy tube (G-tube) is indicated in patients that need long-term pre-pyloric feeding. Endoscopic gastrostomy tube placement is now the preferred modality over surgical gastrostomy owing to a less invasive nature and faster time to start feeding. During endoscopic gastrostomy tube placement, a small incision is made over the anterior abdominal wall through which tube is placed via the push method (the tube is inserted percutaneously through the incision) or the pull technique (the tube is pulled out from the stomach through the incision). Once the tube is placed, the percutaneous tract starts maturing in about 1 to 2 weeks and is usually well formed by 4 to 6 weeks. However, in certain conditions such as severe malnutrition, immunocompromised patients, and large ascites, tract maturity is further delayed. If a PEG tube is dislodged within a month after placement, then endoscopic replacement is recommended. However, if the tube is dislodged after 4 to 6 weeks when tract maturity is expected, bedside replacement is usually sufficient. If the tube is dislodged within 4 weeks of initial placement, patients are at a significant risk of peritonitis and perforation due to peritoneal spillage of gastric contents through the immature track, and replacement should not be attempted without surgical consultation. Blind attempt to re-insert the tube or even foley placement in an immature tract can lead to inadvertent placement of the tube into the peritoneal cavity. This activity reviews what should be done If the tube needs to be replaced after the track is expected to be matured.

Target Audience

This activity has been designed to meet the educational needs of nurse practitioners.

Learning Objectives

At the conclusion of this activity, the learner will be better able to:

• Describe the anatomy of G-tube placement.
• Outline the indications and contraindications for bedside G-tube replacement.
• Outline how to replace displaced G-tube at bedside.

Author(s) / Contributors Disclosure of Conflicts of Interest

Each author, editor, faculty and planning committee member have completed a disclosure form indicating that neither they nor their spouse/partner has a financial interest/arrangement or affiliation that could be perceived as a real or apparent conflict of interest related to the content of this activity.

COMMERCIAL SUPPORT: This activity has received NO commercial support.

Contributors

Hover over the contributor names to see details and disclosures of any financial relationships or relationships they or their spouse/life partner have with commercial interests related to the content of this continuing education activity.

Authors: Rushikesh Shah
Editors: Mili Shah
Editors-In-Chief: 
Chief Medical Reviewer: Sachit Anand
Nurse Planner/Reviewer/Editor: Lisa Haddad
Nurse Planner/Reviewer/Editor: Bernadette Makar
Nurse Planner/Reviewer/Editor: Dorothy Caputo
Pharmacy Planner/Reviewer/Editor: Mark Pellegrini
Physician Planner/Reviewer/Editor: Scott Dulebohn

Continuing Education Accreditation Information

This activity has been planned and implemented in accordance with the Accreditation Standards of the American Association of Nurse Practitioners (AANP) through the joint providership of AKH Inc., Advancing Knowledge in Healthcare and StatPearls Publishing, LLC.  AKH Inc., Advancing Knowledge in Healthcare is accredited by the American Association of Nurse Practitioners as an approved provider of nurse practitioner continuing education. Provider number: 030803.  This activity is approved for 1.00 contact hour(s) (which includes 0 hour(s) of pharmacology).

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Equal Opportunity

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Medium or Media Used:

• Computer Requirements:  Internet Access
• E-mail Address

Instructions for Credit

1. Register for the activity and create a StatPearls login.     
2. Review the required accreditation information:  Target audience, learning objectives, and disclosure information.
3. Complete the entire self-study activity.
4. Complete the post-test assessments.
5. Successfully pass the post-test with a minimum score of 100%.
6. Complete the evaluation form.
7. Obtain a certificate.

StatPearls and AKH adhere to provider standards regarding commercial support of continuing education. It is the policy of StatPearls and AKH that the faculty and planning committee disclose real or apparent conflicts of interest relating to the topics of this educational activity, that relevant conflict(s) of interest are resolved and also that authors and editors will disclose any unlabeled/unapproved use of drug(s) or device(s) during their presentation. Detailed disclosure will be made prior to starting the activity.

The information provided for this activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.

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