[Gastrostomy. Simplified technique and extended field of indications]

The technique by which percutaneous access to the stomach for enteral nutrition is obtained is generally accepted in cases in which swallowing is defective and for aspiration in cases of gastro-intestinal retention. Experience with a gastrostomy tube developed in Denmark has provided inspiration to establish access by means of outpatient intervention. Since 1986, 15 patients with defective swallowing were treated as outpatients with percutaneous introduction of a gastrostomy tube without complications of the intervention or to subsequent management in nursing homes or their own homes. Replacement of the catheter was undertaken by the general practitioner or by renewed outpatient visits. In many of the patients, replacement of the catheter was performed by the caring staff. A narrow-bore tube was chosen primarily in order to reduce the risk of complications. Despite the narrow-bore tube, the effect of the decompression tube has proved satisfactory in five patients since 1986. The method is simple, the trauma minimal and it is well accepted by the patients.