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CC BY-NC-ND 4.0 · Journal of Clinical Interventional Radiology ISVIR 2021; 5(01): 11-15
DOI: 10.1055/s-0041-1723098
Original Article

Radiologically Inserted Gastrostomy (RIG) at a Tertiary Center: Periprocedural Safety including Rationalization of Antibiotic Prophylaxis

Warren Clements 
1   Department of Radiology, Alfred Hospital, Melbourne, Victoria, Australia
2   Department of Surgery, Monash University, Melbourne, Victoria, Australia
3   National Trauma Research Institute, Melbourne, Victoria, Australia
,
Yasmin Shvarts
1   Department of Radiology, Alfred Hospital, Melbourne, Victoria, Australia
,
Jim Koukounaras 
1   Department of Radiology, Alfred Hospital, Melbourne, Victoria, Australia
2   Department of Surgery, Monash University, Melbourne, Victoria, Australia
,
Tuan D. Phan 
1   Department of Radiology, Alfred Hospital, Melbourne, Victoria, Australia
,
Gerard S. Goh 
1   Department of Radiology, Alfred Hospital, Melbourne, Victoria, Australia
2   Department of Surgery, Monash University, Melbourne, Victoria, Australia
,
Tim Joseph 
1   Department of Radiology, Alfred Hospital, Melbourne, Victoria, Australia
,
Ronny Kuang 
1   Department of Radiology, Alfred Hospital, Melbourne, Victoria, Australia
,
Lisa Murnane 
4   Department of Nutrition and Dietetics, Alfred Hospital, Melbourne, Victoria, Australia
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Abstract

Introduction Long-term percutaneous enteral nutrition forms an important part of treatment for patients with an inability to meet nutrient requirements orally. Radiologically inserted gastrostomy (RIG) is an alternative to the traditionally performed percutaneous endoscopic gastrostomy technique. However, there is marked heterogeneity in the way that RIG is performed. In addition, the role for antibiotic prophylaxis during RIG insertion is not clearly established. This study aimed to assess the safety of RIG insertion using our technique including the role of antibiotics in RIG insertion.

Method Retrospective study over 5 years at a tertiary teaching hospital. Periprocedural or early complications within the first 2 weeks of the procedure were collected and correlated with the use of prophylactic antibiotics.

Results A total of 116 patients met the inclusion criteria. 18-French tube was used in 96.6%. Note that 58.6% of procedures were done with intravenous sedation. Prophylactic 1 g cefazolin was used in 70 patients with 1 case of infection. Procedures were performed without antibiotics in 46 patients with 3 infections, p = 0.20.

There were two major complications (1.7%) consisting of right gastric artery injury requiring embolization and gastric wall injury requiring laparotomy. There were 12 minor complications (10.3%) including 4 cases of infection, 3 of severe pain, 1 of minor bleeding, 2 of early dislodgement, and 2 of leak/bypass of gastric contents around the tube.

Conclusion The technique used for RIG insertion at our institution results in a low complication rate. In addition, this study shows no significant difference in early peristomal infection rate with the use of antibiotic prophylaxis.

Keywords

gastrostomy - RIG - antibiotics


Publication History

Article published online:
09 February 2021

© 2021. Indian Society of Vascular and Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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