Guidelines for PEG Tube Removal and Replacement

Indications for Tube Replacement

• Replacement of a percutaneous endoscopic gastrostomy (PEG) tube is indicated when the tube is broken, occluded, dislodged, or has degraded, and can be performed endoscopically, radiologically, surgically, or at the bedside depending on the tube type. 1

Patient Selection for Non‑Endoscopic “Cut‑and‑Push” Removal

• The “cut‑and‑push” technique should be avoided in patients who are at high risk for intestinal obstruction or who have known gastrointestinal strictures. 2

Post‑Removal Monitoring

• After a “cut‑and‑push” removal, clinicians should monitor patients for signs of intestinal obstruction, including abdominal pain, abdominal distension, and vomiting. 2

Timing of Tube Removal

• PEG tube removal may be performed once the gastro‑cutaneous tract has matured, which typically occurs after several weeks of placement; earlier removal requires careful technique selection to minimize complications. [1][2]