Usefulness of transgastrostomic endoscopy (TGE) in patient with post percutaneous endoscopic gastrostomy (PEG)

[Purpose] The aim of this study was to evaluate the observation and treatment by transgastrostomic endoscopy (TGE) using a small-caliber endoscope. [Methods] TGE was performed with a small-caliber endoscope GIF-XP240 (Olympus, Tokyo) to observe upper gastrointestinal tract. Endoscopic mucosal resecrion (EMR) against early gastric cancer was performed with GIF-Q240 (Olympus, Tokyo) supported by TGE using the technique of endoscopic submucosal dissection. J-Tube™ (Boston Scientific, Natick, MA) was also inserted up to upper jejunum through PEG using TGE. [Results] TGE was inserted up to upper jejunum in 47 out of 51 cases. 14 novel lesions following PEG were observed in 46 cases, including reflux esophagitis in 5 cases. We were able to perform easily and safely endoscopic submucosal dissection in 2 cases of early gastric cancer, and insertion of jejunal tube through gastrostomy in 4 cases of aspiration pneumonia. [Conclusion] TGE was useful for the observation and treatment after PEG.