J Korean Radiol Soc.  2008 Apr;58(4):375-379. 10.3348/jkrs.2008.58.4.375.

An Evaluation of the Fluoroscopy-guided Percutaneous Gastrostomy with the Pull Technique

Affiliations
  • 1Department of Diagnostic Radiology, Yonsei University College of Medicine, Korea. jywon@yumc.yonsei.ac.kr

Abstract

PURPOSE
To evaluate the safety and usefulness of the fluoroscopy-guided percutaneous gastrostomy (FPG) using a large profile gastrostomy tube accompanied with the pull technique, and without the use of an endoscopy or a gastropexy.
MATERIALS AND METHODS
From March 2005 to February 2007, 25 patients underwent an FPG using a large profile gastrostomy tube accompanied by the pull technique, in which a 24F pull-type tube was inserted into a patient's mouth and was pulled to the upper abdominal puncture site using a snare, under fluoroscopy. The 18 patients with difficulty swallowing due to muscular atrophic lateral sclerosis or transitional myodystrophy included 5 cases of quadriplegia, 1 case of Parkinson's disease, and 1 metastatic mediastinal tumor. The technical success rate, occurrence of complications, and clinical outcomes were examined.
RESULTS
The technical success rate was found to be 100%. In addition, the retention periods for the indwelling tube ranged from 1 to 24 months (mean: 6.5 months), with all tubes retained at a normal position with normal function. No procedure-related mortality occurred. One patient (4%) did however develop a complication in the form of ascites and ascitic fluid leakage around the tube, which was of hepatic origin and was ultimately resolved after the drainage of ascites.
CONCLUSION
As a result of this study the FPG, accompanied with the pull technique using a 24F tube, should be considered as a safe and effective method for examining patients. It was found to have a high success rate and a low complication rate.

Keyword

Gastrostomy; Stomach; Fluoroscopy; Intubation; Gastrointestinalg

MeSH Terms

Ascites
Ascitic Fluid
Deglutition
Drainage
Endoscopy
Fluoroscopy
Gastropexy
Gastrostomy
Humans
Intubation
Motor Neuron Disease
Mouth
Muscular Dystrophies
Parkinson Disease
Punctures
Quadriplegia
Retention (Psychology)
SNARE Proteins
Stomach
SNARE Proteins
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