Editing PEG insertion (section)

== '''PEG removal''' ==

* At least six weeks post-insertion
* Alternative route available - consider dietician/SP input
* Fast for two hours prior and six hours post
* Consider staged removal of larger devices (>20Fr)
* PPI cover for tracts at higher risk of forming a persistent gastrocutaneous fistula (main proven risk factor is insertion time >8 months)
* Techniques:
** Balloon deflation and pull
** Traction removal
** Cut and push (where traction removal is not possible, and the patient should be able to pass the internal component in stool) - usually do an x-ray one week later

[[Category:Endoscopy]]