Computed Tomography-Guided Percutaneous Gastrostomy/Jejunostomy for Feeding and Decompression

Area of Science:

• Radiology and Imaging
• Gastroenterology
• Interventional Procedures

Background:

• Percutaneous endoscopic gastrostomy (PEG) and jejunostomy (PEJ) are standard for long-term enteral feeding or stomach decompression.
• Endoscopic placement can be challenging or impossible due to factors like inadequate transillumination.
• Computed tomography (CT)-guided PEG/PEJ emerges as a potential alternative in such scenarios.

Purpose of the Study:

• To evaluate the indications, success rates, and complications associated with CT-guided PEG/PEJ procedures.
• To assess the feasibility and safety of CT-guided PEG/PEJ as an alternative to endoscopic placement.

Main Methods:

• A total of 102 consecutive patients underwent CT-guided PEG/PEJ for feeding (n=57) or decompression (n=45).
• The majority (n=98) received a pull-through technique with simultaneous gastroscopy/jejunoscopy.
• Radiation dose metrics, including dose length product and effective dose, were calculated for each patient.

Main Results:

• Successful PEG/PEJ placement was achieved in 87.3% of patients (89/102).
• Feeding tube placement succeeded in 91.2% (52/57), and decompression tube placement in 82.2% (37/45).
• No procedure-related mortality occurred; minor complications (e.g., tube dysfunction, bleeding, leakage) were observed in 13 patients with similar rates between feeding and decompression groups.

Conclusions:

• CT-guided PEG/PEJ is a feasible and safe alternative for patients unsuitable for endoscopic placement.
• The procedure exhibits a low rate of procedure-related morbidity.
• It serves as an attractive alternative to surgical tube placement, with manageable long-term complications like tube disturbances.