CT-Guided Percutaneous Gastrostomy without Preliminary Placement of a Nasogastric Tube

Jiang, Xiongying; Bertrand, Anne-Sophie; Li, Guo; Hébert, Christophe; Marcy, Pierre-Yves; Falewee, M. N.; Iannessi, Antoine

doi:10.1016/j.jvir.2018.08.014

Cited by 7 publications

(7 citation statements)

References 8 publications

(7 reference statements)

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“…Spelsberg et al [ 9 ] initially investigated the feasibility of gastric insufflation by puncturing the stomach wall with a Chiba needle and achieved good results. Jiang et al [ 1 ] also confirmed that it is feasible to inject gas with a Chiba needle without placing a nasogastric tube. However, a recent study demonstrated that gas injection through a Chiba needle has several drawbacks [ 2 ].…”

Section: Discussionmentioning

confidence: 93%

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Safety and Efficacy of CT-Guided Central Venous Catheter Gastric Insufflation in Percutaneous Gastrostomy

Zhang

Deng

Chen

et al. 2022

BioMed Research International

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Gastric insufflation for computed tomography (CT)-guided percutaneous gastrostomy is currently performed via a nasogastric tube or a Chiba needle. However, nasogastric tube placement requires patient pharynx and esophagus, and Chiba needle use is associated with an increased risk of organ damage and prolonged operation time. Herein, we introduce a new method of gastric insufflation via a central venous catheter and explore its safety and efficacy by retrospective analysis of the clinical data of patients who underwent percutaneous gastrostomy using this method in our hospital from April 2021 to March 2022. The extracted data included the following: success rate, operation time, gastric insufflation time, radiation dose, postoperative pain score, and complications. We also compared the preoperative levels of several nutritional indicators (body mass index, hemoglobin, albumin, creatinine, and blood urea nitrogen) with those obtained 1 month postoperatively. A total of 12 patients underwent percutaneous gastrostomy under CT guidance using central venous catheter gastric insufflation. The surgery and gastric insufflation success rates were 100% both. The average operation time, gastric insufflation time, and effective radiation dose were 24.08 ± 5.25 min, 5.08 ± 2.50 min, and 14.16 ± 3.63 mSv, respectively. Based on the World Health Organization scale for pain assessment, five patients reported no postoperative pain and seven patients had mild pain. There were no serious complications, such as stoma infection, peritonitis, gastrointestinal perforation and bleeding, or embedding syndrome. All evaluated nutritional indicators showed improvement at 1 month postoperatively, with statistically significant differences compared to the preoperative values ( p < 0.05 for all). In conclusion, CT-guided percutaneous gastrostomy with central venous catheter gastric insufflation is a safe, effective, and feasible minimally invasive treatment.

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Section: Discussionmentioning

confidence: 93%

“…Computed tomography (CT)-guided percutaneous gastrostomy requires dilation of the stomach to ensure that it is closely adhered to the abdominal wall. Currently, there are two methods of gastric insufflation: via a nasogastric tube and a Chiba needle [ 1 ]. However, both these methods have certain disadvantages.…”

Section: Introductionmentioning

confidence: 99%

Safety and Efficacy of CT-Guided Central Venous Catheter Gastric Insufflation in Percutaneous Gastrostomy

Zhang

Deng

Chen

et al. 2022

BioMed Research International

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“…The most notable feature of these methods is the accurate placement of a ne needle into the gastric cavity. Although reports suggest a 100% success rate for these methods, research on the puncture site for gastric insu ation remains limited [3,[5][6][7][8][9]11].…”

Section: Discussionmentioning

confidence: 99%

A Comparative Analysis of Transhepatic Cardia-Gastric Fundus Puncture vs. Gastric Body puncture for Insufflation for CT-Guided Percutaneous Gastrostomy

Xiao-mei,

Chang-ming,

et al. 2024

Preprint

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Objective: To evaluate the safety and efficacy of transhepatic cardia-gastric fundus puncture (TCFP) for insufflation for CT-guided percutaneous gastrostomy (CPG). Methods: The clinical data of 38 patients who underwent TCFP for insufflation and 161 patients who underwent percutaneous gastric body for insufflation at a single center were retrospectively analyzed. The operative time, success rate, complication rate, overall procedure time, and incidence of complications within three months were collected. Results: The success rate of insufflation was 100%, and no serious complications occurred during percutaneous gastric insufflation. The average time for insufflation via TCFP was 9.60±6.62 minutes, and that via gastric body puncture was 8.71±71.8 minutes, with no significant difference between the two (p=0.485). The overall duration of gastrostomy in the TCFP group was 32.16±10.27 minutes and 33.94±13.82 minutes in the gastric body group, with no significant difference (p=0.456). The incidence of submucosal air spread was 0% in the TCFP group and 9.9% in the gastric body group, with significant difference (p=0.045). The complication rates following insufflation via TCFP and via gastric body puncture were 18.4% and 21.7%, respectively, with no significant difference between the two groups (p=0.652). The perioperative pain score was 2 after insufflation via TCFP and via gastric body puncture, with no significant difference (p=0.119). The overall mortality rate was 0 in the first postoperative month, with a 3-month mortality rate of 5% (10/199). The surviving patients showed a significant increase in weight from 51.81±8.52 kg to 52.52±9.39 kg at 3 months postoperatively (p=0.009). Conclusion: TCFP for insufflation is safe and effective, with a 100% success rate and no increased risk of complications. The choice of procedure should be based on the patient's specific condition and the physician's experience.

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“…In a feasibility study, Jiang et al demonstrated a 100% technical success rate in 13 patients utilizing a two-stick technique. 67 Transesophageal gastric tubes (TEGTs) are another option for patients with MBO. These catheters enter through a small incision at the base of the neck into the cervical esophagus and ultimately terminate in the stomach.…”

Section: Interventional Radiology Options For Decompression Of Mbomentioning

confidence: 99%

Malignant Gastrointestinal Obstruction: Options for Decompression and Nutrition

Litwin

Chan

Huang

2020

Digestive Disease Interventions

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Malignant bowel obstruction (MBO) is a relatively common condition affecting patients with advanced malignancy. Therapeutic interventions should be aimed at maintaining quality of life. Given the lack of prospective controlled studies in this patient population, patient management is often based on local practice patterns and anecdotal experience. To foster a collaborative approach among the members of the patient care team involving internal medicine, oncology, palliative care, clinical nutrition, surgery, gastroenterology, and interventional radiology physicians, it is important to improve our understanding of MBO. The purpose of this article is to describe the clinical presentation, pathophysiology, as well as medical, surgical, and nonsurgical palliative options available to patients with MBO for purposes of decompression and nutrition.

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CT-Guided Percutaneous Gastrostomy without Preliminary Placement of a Nasogastric Tube

Cited by 7 publications

References 8 publications

Safety and Efficacy of CT-Guided Central Venous Catheter Gastric Insufflation in Percutaneous Gastrostomy

Safety and Efficacy of CT-Guided Central Venous Catheter Gastric Insufflation in Percutaneous Gastrostomy

A Comparative Analysis of Transhepatic Cardia-Gastric Fundus Puncture vs. Gastric Body puncture for Insufflation for CT-Guided Percutaneous Gastrostomy

Malignant Gastrointestinal Obstruction: Options for Decompression and Nutrition

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