Gastrostomy is a critical technique in pediatric enteral nutrition support. Currently, percutaneous endoscopic gastrostomy has become the preferred surgical approach due to its minimally invasive nature, while laparoscopic gastrostomy serves as an important alternative for children with anatomical abnormalities or low body weight. The success of pediatric gastrostomy relies on refined management provided by multidisciplinary team collaboration, including strictly comprehensive preoperative assessment and perioperative management. Moreover, the management of pediatric gastrostomy is a systematic process transcending technical itself. The core of long⁃term management hinges on personalized nutrition strategies, proactive treatment and prevention of common complications, and systematic empower education for family caregivers. The ultimate goal is enhancing the quality of life and long⁃term prognosis for children dependent on enteral nutrition by ‌comprehensive and continuous integrated interventions. This paper aims to provide a comprehensive review of surgical approaches, perioperative management, prevention and treatment of complications, and long⁃term management goals for pediatric gastrostomy, thus providing a reference for the full⁃process management of pediatric gastrostomy, and improving the quality of life for these children and their families.

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