Comparison of fluoroscopy-guided Pull-type Percutaneous Radiological Gastrostomy (Pull-type-PRG) with conventional Percutaneous Radiological Gastrostomy (Push-type-PRG): clinical results in 253 patients

Abstract

Compared to the external-internal Push-type-PRG, the internal-external Pull-type-PRG showed a high primary success rate and a decreased incidence of peri-interventional complications.

Percutaneous gastrostomy placement by intervention radiology: Techniques and outcome

“…On the basis of different probing techniques, the pull-type PRG can be divided into the direct retrograde and the antegrade fixation technique. [ 5 ]…”

“…In such cases, a hydrophilic guidewire (0.035 in. ; 180 cm, Terumo, Eschborn, Germany) with 4/5-Fr Cobra/headhunter guiding catheter combination was used to enter the esophagus from the stomach retrogradely until the catheter guidewire combination exited through the mouth[ 5 ] or pulled out through mouth with the help of forceps, when guidewire reaches at the level of nasopharynx. Sometimes a combination of 18 G needle directing towards the gastro-esophageal junction and manipulation of the hydrophilic guide wire was successful to advance the guide wire into the esophagus.…”

“…[ 7 8 ] Pneumoperitoneum was categorized as minor complication if it was nonsymptomatic or symptomatic but resolved without intervention. [ 5 ]…”

“…Major complications were defined as any complication requiring surgery, minor or prolonged hospitalization, intensive care, hemorrhage requiring blood transfusion, tube dislodgement into the peritoneal cavity, or deep stromal infection may or may not necessitating tube removal,[ 7 8 ] and symptomatic pneumoperitoneum requiring repeat intervention (i.e., drainage placement). [ 5 ]…”

“…The second is the “pull-type gastrostomy,” which has been adapted from the PEG technique with an internal/external placement of the respective gastrostomy catheter. [ 5 ]…”