Abstract
Percutaneous Endoscopic Gastrostomy (PEG) is the established first choice procedure for long-term enteral nutrition and/or decompression. However, PEG is not always suitable for the patients who have not indicated because of various reasons. Percutaneous Trans-Esophageal Gastro-tubing (PTEG) is developed for such difficult case of PEG. Using a rupture-free balloon the procedure become improve with safe. The tube in PTEG by first report is inserted from the neck under ultrasonographic control with fluoroscopy, without endoscopy. It has very few complications. However safer procedure is expected. Endoscopic support PTEG is certainly confirmed the every part of procedure directly. The important things in management of PTEG are the measures against the accidental removal and obstruction of the feeding tube which is longer than that of PEG. Major complication is few and skin trouble is less than PEG. It is the state that insurance adaptation stopped at one time, but It is not thought that the number of indicated cases are decreased, and the early adaptation reopening is expected now.
