Update on endoscopic enteral access

Abstract

Enteral access is a common procedure in managing patients in need of enteral nutrition and decompression. Enhancements of technology and improvements in operator skills have resulted in the development of several techniques of enteral access including endoscopic-guided, imaging-guided, laparoscopic-assisted, or combined techniques. Endoscopic enteral access techniques are the most commonly used and preferred method. These include endoscopy-guided nasoenteric tube placement and percutaneous endoscopic enterostomy. These techniques can be safely performed even in challenging conditions such as prior operative intervention, ascites, and head and neck obstructions. However, each type of procedure has its unique set of indication as well as complications. The decision to use endoscopic enteral access should be carefully considered and individualized based on the patient's specific anatomical limitations, preference, overall health status, and disease. In this article, we review current knowledge focusing on endoscopic enteral feeding access including indications, contraindications, preprocedural preparation, procedure technique, enteral access in specific conditions, postprocedural care, and prevention and management of associated complications.