Percutaneous Radiologic Gastrostomy: A 12-Year Series

Abstract

Background/Aims: Interventional radiologists have played a main role in the technical evolution of gastrostomy, from the first surgical/endoscopical approaches to percutaneous interventional procedures. This study evaluated the results obtained in a 12-year series. Methods: During the period December 1996 to December 2008, 254 new consecutive gastrostomies and 275 replacement procedures were performed in selected patients. All of the cases were treated by a T-fastener gastropexy and tube placement. The procedures were assessed by analyzing indications, patient selection, duration of the procedures, and mortality. Results: All 254 first gastrostomies were successful; replacement procedures were also successfully performed. One (0.2%) patient with severe neurologic disorders died after the procedure without signs of procedure-related complications, and seven (1.3%) major complications occurred (four duodenal lesions with peritoneal leakage, two gastric bleedings, and one gastric lesion). Minor complications were easily managed; three tube ruptures were resolved. Conclusions: This long-term series and follow-up showed that a group of interventional radiologist can effectively provide gastrostomy placement and long-term tube management. Percutaneous gastrostomy is less invasive than other approaches and it satisfies the needs even of high-risk patients. (Gut Liver 2010;4(Suppl. 1):S44-49)

Radiologically Guided Placement of Mushroom-retained Gastrostomy Catheters: Long-term Outcomes of Use in 300 Patients at a Single Center

“…In addition, patients who have very low. These benefits have led to recommendations for use of RIG in patients at higher risk or those in whom endoscopy is technically challenging or contraindicated (19)(20)(21)(22)(23).…”

Analysis of Patients’ X-ray Exposure in 146 Percutaneous Radiologic Gastrostomies

“…However, there was no indication of whether these were median or mean values. Perona et al [3] quantify the mean fluoroscopy time at only 2.12 minutes. However, the mean in this article was based on 254 primary PRG insertions and 275 replacements.…”

“…First, upper abdominal sonography was performed to mark the hepatic border. After placement of a nasogastric tube, the stomach was distended with ambient air [2,3,16], and extensive local anesthesia was performed from the cutis to the frontal wall of the stomach. Two gastropexies applied diametrically around the gastrostomy itself prevent diversion of the stomach during dilatation of the pathway.…”

“…The fluoroscopy time is stated by only five authors (2.1 -12.6 min) [3, 9 -12]. Only in the case of one study is the patient cohort larger than the cohort presented here [3]. To date there has been no investigation into the relationship between DAP and fluoroscopy time on the intraprocedural placement of an orally or nasally inserted nasogastric tube (NGT) or the detector type used.…”

Percutaneous endoscopic caecostomy for severe constipation in adults: feasibility, durability, functional and quality of life results at 1 year follow-up

“…Chronic local wound pain has been described by Biyani et al without clear explanations [19]. Injury to pain sensitive fibres from ilioinguinal and iliohypogastric nerves that traverse through the right iliac fossa, as well as pain and irritation around T-fastener anchors can be proposed as possible explanations [27,28]. Better understanding and innovative treatment modalities are needed, such as recently proposed with radiofrequency neurolysis in chronic inguinal neuralgia following surgical procedures [29].…”