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Updated: Sep 20, 2025

Author Spotlight: Point-of-Care Ultrasound for Gastric Content Assessment and Risk Stratification in Perioperative Care
Published on: September 22, 2023
Ultrasound-Guided Gastrostomy Tube Placement: An Evaluation of Postoperative Complications in the Pediatric
Danielle Dougherty1, Nathan S Rubalcava1, Olivia G Janke2
1Section of Pediatric Surgery, Department of Surgery, University of Michigan, Michigan Medicine, Ann Arbor, Michigan, USA.
Insights
Ultrasound-guided gastrostomy tube placement is a safe pediatric procedure. This method showed complication rates comparable to laparoscopic gastrostomy tube placement in a comparative study.
Area of Science:
- Pediatric Surgery
- Medical Imaging
- Gastroenterology
Background:
- Gastrostomy tube placement is common in pediatric patients.
- Ultrasound guidance offers a potentially less invasive alternative for gastrostomy tube placement.
- Comparing complication rates between ultrasound-guided and laparoscopic methods is crucial for clinical decision-making.
Purpose of the Study:
- To evaluate short- and long-term postoperative complications of ultrasound-guided gastrostomy tube placement (USGTP).
- To compare these complications with those following laparoscopic gastrostomy tube placement (LGTP).
Main Methods:
- Retrospective chart review of pediatric patients undergoing USGTP (n=41) and LGTP (n=120).
- Comparison of demographics and 30-day/6-month postoperative complications.
- Phone survey (n=26) to identify additional USGTP complications.
Main Results:
- No significant demographic differences between USGTP and LGTP groups.
- Comparable rates of emergency department visits for postoperative complications within 30 days (8% USGTP vs. 6% LGTP) and 6 months (13% USGTP vs. 11% LGTP).
- Long-term phone survey revealed a 35% ED visit rate for USGTP, consistent with literature for minimally invasive procedures.
Conclusions:
- Ultrasound-guided gastrostomy tube placement is a safe and feasible alternative in the pediatric population.
- Postoperative complication rates for USGTP are comparable to those of LGTP.
Abstract:
Using ultrasound guidance has been demonstrated as a feasible alternative method for gastrostomy tube placement in the pediatric population. The aim of this study is to evaluate short- and long-term postoperative complications after ultrasound-guided gastrostomy tube placement (USGTP) and to compare them with complications after laparoscopic gastrostomy tube placement (LGTP). A retrospective chart review evaluated patients who underwent USGTP (n = 41) and LGTP (n = 120) at the same institution. Comparisons were made between the two groups in the context of demographics as well as 30-day and 6-month postoperative complications. A phone survey (n = 26) further identified USGTP complications potentially not captured in the electronic medical records. There were no significant differences in age, gender, and indication for procedure between the two groups. Chart review revealed that USGTP and LGTP had statistically comparable rates of emergency department (ED) visits for postoperative complications. Among USGTP patients, 8% had a recorded ED visit within 30 days of the operation and 13% presented to the ED within 6 months, compared with 6% and 11%, respectively, in the LGTP group (P = .65, P = .69). The USGTP phone survey reported total complications over an average postoperative follow-up time of 34.6 months (range 8-87) and revealed a total ED visit rate of 35%, which is comparable with rates reported in the literature for minimally invasive feeding tube placement. USGTP is a safe and feasible alternative option for gastrostomy tube placement in the pediatric population and it has postoperative complication rates that are comparable with LGTP.
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