The role of endoscopically placed feeding or decompression tubes

Endoscopically placed gastrostomy tubes are often considered in palliative care settings, but the scientific basis for establishing benefit or harm is limited by a dearth of methodologically adequate studies. Decisions must be preceded by an honest discussion of risks and benefits of artificial nutrition in a particular setting, filtered through the values of each patient and family. The use of percutaneous endoscopic gastrostomy (PEG) placement should honor patient autonomy and arise from the determination of the goals of care. PEG tubes for decompression are often efficacious for symptom relief. Overall, the morbidity related to the PEG procedure used for decompression is only slightly higher than when the same technique is used for nutritional purposes.