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Radiologic peroral gastrostomy
J A Clark1, R A Pugash, R R Pantalone
1Department of Medical Imaging, University of Toronto, St. Michael's Hospital, Ontario, Canada.
Purpose:
To develop an improved percutaneous technique for the insertion of large-bore gastrostomy tubes.
Materials And Methods:
With use of fluoroscopic guidance, the stomach is punctured and the esophagus is catheterized in a retrograde fashion. A guide wire is passed from the gastrostomy site, up the esophagus, and out of the patient's mouth. A large-bore (20-24 F) endoscopic push-type gastrostomy tube is advanced over the wire, through the mouth, down the esophagus, and out of the gastrostomy site.
Results:
Thirty-one successful tube placements were performed in 32 attempts (97% success rate). There were no major procedural or postprocedure complications. Minor complications included one lip laceration (one of 31 = 3%), one minor exit site infection (one of 31 = 3%), and two inadvertent tube dislodgements (two of 31 = 6%).
Conclusions:
Radiologic placement of large-bore endoscopic gastrostomy tubes is possible without endoscopy. The procedure is rapid, easy to perform, and safe.