Percutaneous Endoscopic Gastrostomy (PEG) is an endoscopically guided, percutaneously punctured gastrostomy tube, with nutrient solution infused directly into the stomach through the PEG feeding tube for gastrointestinal nutrition and other therapeutic purposes, PEG provides a safe and effective way to establish long-term enteral nutrition access. . At present, this procedure is very widely used in developed countries, while its application in China is extremely limited and urgently needs to be promoted and popularized. Since the introduction of this technology in 2004, our endoscopy department has performed gastroscopic gastrostomy for nearly 30 patients with excellent results, and has promoted this technology to Dali, Lincang, Wenshan and other hospitals. In order to meet the nutritional needs of the body, nasal feeding tubes or surgical gastrostomy were often used in the past. However, both of these methods have great disadvantages. If left for a long time, the nasal feeding tube not only makes the patient feel obvious discomfort in the nasopharynx, but also causes mucosal erosion, bleeding and stenosis in the nasopharynx and esophagus, and is easily withdrawn by the patient himself. PEG is a very practical endoscopic treatment technique, which requires an operating room, complicated anesthesia and surgical procedures, and complicated postoperative care with many complications. Compared with the traditional caesarean gastrostomy, PEG is less invasive, easier to operate, shorter operation time, safer, more economical, and easier to care for after surgery, and the complications and mortality rate are significantly reduced, which has replaced the traditional surgical gastrostomy. the PEG tube is left for a long time, up to more than 4 years. PEG was originally designed to provide a long-term enteral nutrition route for patients who had normal gastrointestinal function but were unable to feed themselves orally. Nowadays, the indications for PEG are expanding and have been applied to people with burns, esophageal cancer, head and neck cancer, and even patients with severe maxillofacial trauma can benefit from PEG. The prerequisites for performing PEG are those who have impaired transoral feeding for various reasons, but have normal gastrointestinal function and require long-term (more than 2-3 weeks) tube feeding nutritional support or require long-term gastrointestinal decompression. Specific indications are as follows: those with central nervous system diseases leading to swallowing disorders (e.g. stroke, traumatic brain injury, vegetative state, etc.); before and after radiotherapy or surgery for head and neck tumors (nasopharynx, oral cavity); esophageal perforation, esophageal fistula, extensive scar formation in the esophagus; insufficient intake (e.g. burn, AIDS, anorexia, bone marrow transplant recipients); those with extra-biliary fistula, external bile drainage; severe pancreatitis, pancreatic cyst, gastric emptying disorders ( jejunostomy tube); persistent and persistent vomiting due to various reasons (tumor chemotherapy, etc.), etc. There are also contraindications to PEG surgery, which are divided into absolute contraindications and relative contraindications. Absolute contraindications include: coagulation disorders, peritonitis, peritoneal dialysis, varicose veins in the gastric wall, absence of stomach and any disease that cannot be examined by gastroscopy. Relative contraindications such as patients with massive ascites, patients who cannot see the transillumination point from the abdominal wall during PEG, usually because of morbid obesity or the presence of other structures between the stomach and the abdominal wall. The absence of other tissue structures between the two can be clarified by endoscopy and abdominal ultrasound and CT scan, and the puncture can be performed under their guidance. In obese patients, the skin and subcutaneous tissues can be incised under local anesthesia, and then the PEG operation can be performed safely. PEG can not only play the role of long-term enteral nutrition, but also can be applied in the perioperative period in some special patients, and can also play the role of gastrointestinal decompression. Fistula tubes should be replaced and removed in a timely manner. In many patients, the fistula can be removed directly from the body because the patient is improving and can eat through the mouth on his own without tube feeding through the fistula. However, the tube must be removed after sinus tract formation, usually at least 28 days after placement. Postoperative incisional infections are more common after PEG, and possible complications include minor and serious complications. Minor complications include: incisional infection, slippage and displacement of the fistula, paracentesis leakage, blockage of the fistula, and incisional hematoma. Serious complications include: bleeding, aspiration, peritonitis, endogastric pad syndrome, and gastric fistula. Complications can be effectively avoided through infection prevention, aseptic operation, strict compliance with operating procedures, and careful postoperative care. Intermittent feeding can be performed after PEG tube placement, which has the advantages of easy implementation, good tolerance and physiological compliance. The right amount of enteral nutrients should be injected each time to avoid gastroesophageal reflux due to rapid and large infusion. In addition, the patient should be kept in a semi-recumbent position to reduce the risk of accidental aspiration. After discharge from the hospital, patients can continue to use PEG for continuous enteral nutrition support at home to maintain normal nutritional status. If abnormalities such as skin redness and pain around the stoma tube or obstruction of the stoma tube occur, they should be promptly seen in the hospital.