Gastrostomy (G Tube or “PEG”) and Gastrojejunostomy Tube (GJ Tube) Placement

PREOP EVALUATION

  • Clinic Visit (if not for an inpatient)
  • CBC and PT/INR
  • If G or GJ placement because of head and neck cancer, needs CT or MRI of head/neck within one month of scheduled procedure
  • Should be referred to Autumn from Apria:  (408) 598-5473) for enteral feeding consult

TIMING / BED REST AFTER PROCEDURE

  • 23 hour observation with ongoing IVF (NS at 75 ml/hr) if patient is not eating by month.
  • If this is a preventive feeding tube for a patient with head and neck cancer, patient will be discharged in the same day

ANTICOAGULATION/ANTIPLATELETS

  • Aspirin or Plavix do not stop
  • Lovenox, Low Molecular Weight Heparin (LMWH), Arixtra – Stop 24h prior to procedure
  • Pradaxa – stop 3 days prior to procedure if possible.  See “Warfarin” immediately below for “bridge” anticoagulation, if necessary (CONTACT IR physician if uncertain)
  • Warfarin (Coumadin) – Depends upon procedure and indication, as well as the reason the patient is taking this medication (CONTACT IR physician or PA)

LOCATION OF THE PROCEDURE

  • Cath lab

PREOPERATIVE ORDERS

  • NPO after midnight except meds with sips of water
  • IV with NS (Normal Saline) 75ml/hr

FOLLOW UP

Should be referred to Autumn from Apria:  (408) 598-5473) for enteral feeding consult

  • Call 1-2 days after procedure
  • Schedule patient for tube change every 3-4 months

Gastrostomy tube.png

Gastrostomy tube: the tube tip is located in the stomach

Gastro-jejunostomy tube: the tube tip is located in the jejunum