Computed tomography-guided percutaneous gastrostomy: initial experience at a cancer center

Abstract

Gastrostomy is indicated for patients with conditions that do not allow adequate oral nutrition. To reduce the morbidity and costs associated with the procedure, there is a trend toward the use of percutaneous gastrostomy, guided by endoscopy, fluoroscopy, or, most recently, computed tomography. The purpose of this paper was to review the computed tomography-guided gastrostomy procedure, as well as the indications for its use and the potential complications.

What the radiologist should know about the role of percutaneous gastrostomy: a pictorial essay

“…Percutaneous gastrostomy is a safe, effective procedure, with good success rates and low complication rates, being feasible when conventional techniques cannot be performed. The main limitation of percutaneous gastrostomy is the smaller tube size, which can lead to a higher obstruction rate ( 4 , 6 , 8 - 11 ) .…”

“…The retention balloon is inflated, and the tube is partially retracted for adequate fixation to the anterior gastric wall. All steps of the procedure and the final position of the probe are confirmed by CT ( 11 ) , as illustrated in Figure 2 . In brief, the steps are as follows: guided puncture; insertion of fasteners; puncture between fasteners; dilation of the path along the guidewire; detachable sheath insertion; passage of the tube over the guidewire; and balloon inflation.…”

O que o radiologista deve saber sobre o papel da gastrostomia percutânea: ensaio iconográfico

“…O balão de retenção é inflado e a sonda é tracionada para adequada fixação da parede gástrica anterior. Todos os passos do procedimento e a posição final da sonda são confirmados por TC (11) (Figura 2). Passo a passo: punção guiada; inserção das pexias; punção entre as pexias; dilatação do trajeto baseada no fio-guia; inserção de bainha destacável; passagem do tubo com auxílio do fio-guia; insuflação do balão.…”

Prevention of PEG Tube Misplacement in the Transverse Colon: Method of Introducing a Gastrografin into the Stomach

“…Computed tomography-guided PEG placement is an optional method for the estimation of intraabdominal, anatomical orientations that may minimize the risk of complications [23,24] ; however, CT scan cannot be use under gastrostomy. Another CT-guided PEG placement is useful under gastrostomy when an endoscope cannot pass through the stenosis or occlusion of pharynx due to head and neck cancer [25] , but the manipulation of gastrostomy is complicated, has a long procedure time, and required exposure to radiation. Therefore, although Figure 5 An 89-year-old female underwent surgical gastrostomy because the transverse colon was positioned high behind the ribs.…”