Comparison of these techniques has shown them to be equivalent in safety. This can be accomplished by pulling the tube with an endoscope or pushing it over a guide wire. These techniques are more difficult and less successful than PEG placement. Jejunostomy tubes tend to migrate or occlude frequently, necessitating frequent manipulation. PEG tubes can be removed when no longer needed or when not adequately functioning.
Some tubes require endoscopic extraction while others are designed for removal by external traction.
The decision whether or not to use endoscopy to remove a PEG that cannot be removed by external traction depends on the type of tube in place and should be individualized. Tracts usually close within 24 hours. In patients who need continued enteral nutrition, several types of replacement devices are available. Neurologic disorders and head and neck cancer are the most common indications. PEGs are also used for gastric decompression in selected patients.