Percutaneous gastrostomy: use of intragastric balloon support.

vanSonnenberg, Eric; Cubberley, D A; Brown, LK; Wittich, G R; Lyon, J. W.; Stauffer, Alexandra

doi:10.1148/radiology.152.2.6739827

Cited by 18 publications

(4 citation statements)

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“…Alternatively, distension of the stomach can be achieved by means of an intragastric balloon mounted on a nasogastric tube for fluoroscopically guided gastrostomy (10). If a nasogastric tube cannot be inserted, a successful puncture is less likely, and a higher rate of complications can be expected (II,12).…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Gastrostomy Guided by Ultrasound and Fluoroscopy

Lorentzen¹,

Skjoldbye²,

Nolsøe³

et al. 1995

Acta Radiol

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Percutaneous gastrostomy, utilizing a dedicated catheterization kit, with a combination of ultrasonographic (US) and fluoroscopic guidance, was carried out in 27 patients. The main indication for gastrostomy was the need for nutritional support in malignant esophageal stricture. After distending the stomach with water via a nasogastric tube, the gastric antrum was punctured under US guidance and a guide wire was inserted, followed by fluoroscopically guided tract dilatation and insertion of a 2.S-mm Cope-loop catheter. In all patients but one (96%) the procedure was successfully completed in one or 2 attempts. Two complications occurred: one case of a small subcutaneous abscess near the puncture site, and one late incident of dislodgement of a catheter without string-loop fixation, which had been inserted at a catheter exchange after 6 weeks. Percutaneous gastrostomy guided by US and fluoroscopy is a safe and efficacious alternative to endoscopic and surgical gastrostomy.

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Section: Discussionmentioning

confidence: 99%

Percutaneous Gastrostomy Guided by Ultrasound and Fluoroscopy

Lorentzen¹,

Skjoldbye²,

Nolsøe³

et al. 1995

Acta Radiol

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“…Numerous modifications have been described to improve access to the surgically altered stomach, including balloon distension or CT guidance to better identify the stomach, longer needles and peel-away sheaths to access higher or deeper stomachs, and even a transhepatic approach can be undertaken in certain cases. 15,17,48,[53][54][55] Despite these advances, it is impossible in some instances to safely achieve percutaneous access to the stomach, and at such times, the patient should be considered for an open surgical approach.…”

Section: Modifications For Difficult Casesmentioning

confidence: 99%

Percutaneous Gastrostomy and Gastrojejunostomy

Lyon

Pascoe

2004

Semin intervent Radiol

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Gastrostomy allows enteral nutrition to continue in patients who are unable to meet their caloric requirements orally. Though the indications for gastrostomy placement are varied, dysphagia secondary to a neurological condition is the most common. These catheters were initially placed surgically, but percutaneous endoscopic placement is now the routine in most centers. Interventional radiologists have been performing this procedure under fluoroscopic guidance for several years with encouraging results. Percutaneous radiological gastrostomy is reported to have a success rate comparable to that of the endoscopic method, with lower morbidity and mortality rates. A further benefit is that it may be performed in patients for whom the endoscopic method would be difficult or dangerous, such as those with head and neck malignancies. One of the main factors currently limiting the use of this procedure is the shortage of interventional radiology facilities and specialists.This article describes a technique for routine percutaneous radiological gastrostomy catheter placement and procedural variations for difficult cases. Indications and contraindications will be discussed, as will complication rates and how these compare with the traditional methods of gastrotomy tube placement. KEYWORDS: Gastrostomy, gastrojejunostomy, interventional radiologyObjectives: Upon completion of this article, the reader will (1) understand how gastrostomy provides a mechanical means for the continuation of enteral nutrition in patients who are unable to meet their caloric requirements and (2) be able to describe a technique for routine percutaneous radiological gastrostomy catheter placement, procedural variations, indications and contraindications, as well as success and complication rates and how these compare with nonradiological methods of gastrostomy tube placement. Accreditation: Tufts University School of Medicine (TUSM) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Credit: TUSM designates this educational activity for a maximum of 1 Category 1 credit toward the AMA Physicians Recognition Award. Each physician should claim only those credits that he/she actually spent in the activity.Gastrostomy provides access for enteral nutrition in patients for whom oral intake is either impossible or unsafe, and for others who are unable to achieve an adequate caloric intake orally. It can also be used for palliative decompression of proximal small bowel or gastric outlet obstruction. The ideal procedure should provide an effective and aesthetically acceptable gastrostomy, at low cost, with minimal risk of both short-and long-term complications.

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“…There are a number of technical modifications to the procedure; however, which can make it possible in these difficult circumstances. These include balloon distension of the stomach, and the use of CT or fluoroscopy to guide placement of the feeding tube [24,25,26,27,28]. Minor procedural changes, such as the use of a longer needle or peel-away sheath, have resulted in a much improved success rate [29].…”

Section: Contraindicationsmentioning

confidence: 99%

The role of the interventional radiologist in enteral alimentation

2004

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The provision of enteral nutrition through the placement of gastrostomy/gastrojejunostomy tubes is a well-established procedure. Traditionally, these catheters have been placed either surgically or endoscopically; however, over the past two decades interventional radiologists have increasingly performed these procedures successfully. The perceived advantages of this route lie in the reported lower morbidity and mortality rates. In addition, percutaneous radiologically guided (PRG) catheters may be placed in certain subgroups of patients in whom it would be technically difficult or impossible by other routes, e.g., patients with head and neck or oesophageal tumours. The aim of this review is to describe the techniques of radiologically placed gastrostomy/gastrojejunostomy, discuss its indications and contraindications, describe any associated potential complications and compare PRG results with the more established techniques of open surgical and endoscopic placement. We also describe some recent procedural and catheter modifications.

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Percutaneous gastrostomy: use of intragastric balloon support.

Cited by 18 publications

References 0 publications

Percutaneous Gastrostomy Guided by Ultrasound and Fluoroscopy

Percutaneous Gastrostomy Guided by Ultrasound and Fluoroscopy

Percutaneous Gastrostomy and Gastrojejunostomy

The role of the interventional radiologist in enteral alimentation

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