Subscribe to RSS
Please copy the URL and add it into your RSS Feed Reader.
https://www.thieme-connect.de/rss/thieme/en/10.1055-s-00032260.xml
Download PDF
Digestive Disease Interventions 2023; 07(04): 240-248
DOI: 10.1055/s-0043-1771310
DOI: 10.1055/s-0043-1771310
Review Article
Enteric Access: IR Perspective
Abstract
Gastrostomy tube placement may be needed for nutritional support, as in the setting of neurogenic dysphagia or head and neck malignancy, or for gastric decompression, as in the setting of malignant small bowel obstruction. Additionally, gastrojejunostomy or direct jejunostomy tubes may be needed in the setting of gastric outlet obstruction among other indications. Surgical, endoscopic, and percutaneous approaches are all well-described with generally similar outcomes. In this article, the standard radiologic percutaneous gastrostomy technique is reviewed including both the “push” and “pull” methods. Then, the special indications and techniques of advanced percutaneous enteral access such as percutaneous transesophageal gastrostomy and direct jejunostomy are discussed with examples shown.
Publication History
Received: 04 June 2023
Accepted: 17 June 2023
Article published online:
11 September 2023
© 2023. Thieme. All rights reserved.
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
References
- 1 Sarr MG, Bass P, Woodward E. The famous gastrocutaneous fistula of Alexis St. Martin. Why didn't it close? Or should we refer to it as a gastric stoma?. Dig Dis Sci 1991; 36 (10) 1345-1347
- 2 Cunha F. Gastrostomy: It's inception and evolution. Am J Surg 1946; 72: 610-634
- 3
Gauderer MW,
Ponsky JL,
Izant Jr RJ.
Gastrostomy without laparotomy: a percutaneous endoscopic technique. J Pediatr Surg
1980; 15 (06) 872-875
MissingFormLabel
- 4 Preshaw RM. A percutaneous method for inserting a feeding gastrostomy tube. Surg Gynecol Obstet 1981; 152 (05) 658-660
- 5 Ho CS. Percutaneous gastrostomy for jejunal feeding. Radiology 1983; 149 (02) 595-596
- 6 Tao HH, Gillies RR. Percutaneous feeding gastrostomy. AJR Am J Roentgenol 1983; 141 (04) 793-794
- 7 Wills JS, Oglesby JT. Percutaneous gastrostomy. Radiology 1983; 149 (02) 449-453
- 8 Cosentini EP, Sautner T, Gnant M, Winkelbauer F, Teleky B, Jakesz R. Outcomes of surgical, percutaneous endoscopic, and percutaneous radiologic gastrostomies. Arch Surg 1998; 133 (10) 1076-1083
- 9 McLoughlin RF, So B, Gray RR. Fluoroscopically guided percutaneous gastrostomy: current status. Can Assoc Radiol J 1996; 47 (01) 10-15
- 10 Wollman B, D'Agostino HB, Walus-Wigle JR, Easter DW, Beale A. Radiologic, endoscopic, and surgical gastrostomy: an institutional evaluation and meta-analysis of the literature. Radiology 1995; 197 (03) 699-704
- 11 Sutcliffe J, Wigham A, Mceniff N, Dvorak P, Crocetti L, Uberoi R. CIRSE standards of practice guidelines on gastrostomy. Cardiovasc Intervent Radiol 2016; 39 (07) 973-987
- 12 Özmen MN, Akhan O. Percutaneous radiologic gastrostomy. Eur J Radiol 2002; 43 (03) 186-195
- 13 O'Keeffe F, Carrasco CH, Charnsangavej C, Richli WR, Wallace S, Freedman RS. Percutaneous drainage and feeding gastrostomies in 100 patients. Radiology 1989; 172 (02) 341-343
- 14 Ryan JM, Hahn PF, Mueller PR. Performing radiologic gastrostomy or gastrojejunostomy in patients with malignant ascites. AJR Am J Roentgenol 1998; 171 (04) 1003-1006
- 15 Hicks ME, Surratt RS, Picus D, Marx MV, Lang EV. Fluoroscopically guided percutaneous gastrostomy and gastroenterostomy: analysis of 158 consecutive cases. AJR Am J Roentgenol 1990; 154 (04) 725-728
- 16 Given MF, Hanson JJ, Lee MJ. Interventional radiology techniques for provision of enteral feeding. Cardiovasc Intervent Radiol 2005; 28 (06) 692-703
- 17 Itkin M, DeLegge MH, Fang JC. et al; Interventional Radiology and American Gastroenterological Association; American Gastroenterological Association Institute; Canadian Interventional Radiological Association; Cardiovascular and Interventional Radiological Society of Europe. Multidisciplinary practical guidelines for gastrointestinal access for enteral nutrition and decompression from the society of interventional radiology and American Gastroenterological Association (AGA) institute, with endorsement by Canadian Interventional Radiological Association (CIRA) and Cardiovascular and Interventional Radiological Society of Europe (CIRSE). J Vasc Interv Radiol 2011; 22 (08) 1089-1106
- 18 Gasparetto A, Rosenberg M, Hunter D, Golzarian J, D'Souza D. Percutaneous gastric tube placement: comparison of trans-abdominal and trans-oral approach in patients with chronic ascites. Diagn Interv Imaging 2019; 100 (01) 25-29
- 19 Al-Holou WN, Wilson TJ, Ali ZS. et al. Gastrostomy tube placement increases the risk of ventriculoperitoneal shunt infection: a multiinstitutional study. J Neurosurg 2018; 131: 1-6
- 20 Gassas A, Kennedy J, Green G. et al. Risk of ventriculoperitoneal shunt infections due to gastrostomy feeding tube insertion in pediatric patients with brain tumors. Pediatr Neurosurg 2006; 42 (02) 95-99
- 21 Janes SEJ, Price CSG, Khan S. Percutaneous endoscopic gastrostomy: 30-day mortality trends and risk factors. J Postgrad Med 2005; 51 (01) 23-28 , discussion 28–29
- 22 Nair S, Hertan H, Pitchumoni CS. Hypoalbuminemia is a poor predictor of survival after percutaneous endoscopic gastrostomy in elderly patients with dementia. Am J Gastroenterol 2000; 95 (01) 133-136
- 23 Higaki F, Yokota O, Ohishi M. Factors predictive of survival after percutaneous endoscopic gastrostomy in the elderly: is dementia really a risk factor?. Am J Gastroenterol 2008; 103 (04) 1011-1016 , quiz 1017
- 24 Blomberg J, Lagergren P, Martin L, Mattsson F, Lagergren J. Albumin and C-reactive protein levels predict short-term mortality after percutaneous endoscopic gastrostomy in a prospective cohort study. Gastrointest Endosc 2011; 73 (01) 29-36
- 25 Johnston SD, Tham TC, Mason M. Death after PEG: results of the National Confidential Enquiry into Patient Outcome and Death. Gastrointest Endosc 2008; 68 (02) 223-227
- 26 Tominaga N, Shimoda R, Iwakiri R. et al. Low serum albumin level is risk factor for patients with percutaneous endoscopic gastrostomy. Intern Med 2010; 49 (21) 2283-2288
- 27 Mirich DR, Gray RR. Infracolic percutaneous gastrojejunostomy: technical note. Cardiovasc Intervent Radiol 1989; 12 (06) 340-341
- 28 Oishi H, Shindo H, Shirotani N, Kameoka S. A nonsurgical technique to create an esophagostomy for difficult cases of percutaneous endoscopic gastrostomy. Surg Endosc 2003; 17 (08) 1224-1227
- 29 Friedmann R, Feldman H, Sonnenblick M. Misplacement of percutaneously inserted gastrostomy tube into the colon: report of 6 cases and review of the literature. JPEN J Parenter Enteral Nutr 2007; 31 (06) 469-476
- 30 Itkin M, DeLegge MH, Fang JC. et al; Interventional Radiology and American Gastroenterological Association; American Gastroenterological Association Institute; Canadian Interventional Radiological Association; Cardiovascular and Interventional Radiological Society of Europe. Multidisciplinary practical guidelines for gastrointestinal access for enteral nutrition and decompression from the Society of Interventional Radiology and American Gastroenterological Association (AGA) Institute, with endorsement by Canadian Intervention. J Vasc Interv Radiol 2011; 22 (08) 1089-1106
- 31 Lyon SM, Pascoe DM. Percutaneous gastrostomy and gastrojejunostomy. Semin Intervent Radiol 2004; 21 (03) 181-189
- 32 de Baere T, Chapot R, Kuoch V. et al. Percutaneous gastrostomy with fluoroscopic guidance: single-center experience in 500 consecutive cancer patients. Radiology 1999; 210 (03) 651-654
- 33 Ho CS, Yeung EY. Percutaneous gastrostomy and transgastric jejunostomy. AJR Am J Roentgenol 1992; 158 (02) 251-257
- 34 Munk PL, Lee MJ, Poon PY. et al. Percutaneous gastrostomy in radiologic practice. Australas Radiol 1997; 41 (04) 342-350
- 35 Kanazawa S, Naomoto Y, Hiraki Y, Yasui K, Matsuno T. Percutaneous feeding gastrostomy in patients with a partial gastrectomy: transhepatic approach with CT guidance. Abdom Imaging 1995; 20 (04) 302-306
- 36 Sanchez RB, vanSonnenberg E, D'Agostino HB, Goodacre BW, Moyers P, Casola G. CT guidance for percutaneous gastrostomy and gastroenterostomy. Radiology 1992; 184 (01) 201-205
- 37 Oppenheimer J, Ray Jr CE, Kondo KL. Miscellaneous pharmaceutical agents in interventional radiology. Semin Intervent Radiol 2010; 27 (04) 422-430
- 38 Thornton FJ, Fotheringham T, Haslam PJ, McGrath FP, Keeling F, Lee MJ. Percutaneous radiologic gastrostomy with and without T-fastener gastropexy: a randomized comparison study. Cardiovasc Intervent Radiol 2002; 25 (06) 467-471
- 39 Shin JH, Song H-Y, Kim T-H, Kim KR, Choi KE, Kim JH. Percutaneous radiologic gastrostomy: a modified Chiba-needle puncture technique with single gastropexy. Abdom Imaging 2010; 35 (02) 189-194
- 40 Kim J-W, Song H-Y, Kim KR, Shin JH, Choi EK. The one-anchor technique of gastropexy for percutaneous radiologic gastrostomy: results of 248 consecutive procedures. J Vasc Interv Radiol 2008; 19 (07) 1048-1053
- 41 Lowe AS, Laasch HU, Stephenson S. et al. Multicentre survey of radiologically inserted gastrostomy feeding tube (RIG) in the UK. Clin Radiol 2012; 67 (09) 843-854
- 42 O'Dowd M, Given MF, Lee MJ. New approaches to percutaneous gastrostomy. Semin Intervent Radiol 2004; 21 (03) 191-197
- 43 Cantwell CP, Gervais DA, Hahn PF, Mueller PR. Feasibility and safety of infracolic fluoroscopically guided percutaneous radiologic gastrostomy. J Vasc Interv Radiol 2008; 19 (01) 129-132
- 44 Wong J, Ganti S, Mullan D. et al. Infra-colic gastrostomy: technique and anatomical considerations. Int J Gastrointest Interv 2021; 10 (01) 12-16
- 45 Gubler C, Wildi SM, Bauerfeind P. Liver injury during PEG tube placement: report of two cases. Gastrointest Endosc 2005; 61 (02) 346-348
- 46 Chaer RA, Rekkas D, Trevino J, Brown R, Espat J. Intrahepatic placement of a PEG tube. Gastrointest Endosc 2003; 57 (06) 763-765
- 47 Tam A, Wagner-Bartak NA, Wallace MJ, Murthy R. Liver abscess after inadvertent transhepatic transgression during percutaneous fluoroscopy-guided gastrostomy. Clin Radiol 2008; 63 (06) 731-735
- 48 Varney RA, vanSonnenberg E, Casola G, Sukthankar R. Balloon techniques for percutaneous gastrostomy in a patient with partial gastrectomy. Radiology 1988; 167 (01) 69-70
- 49 Toh Yoon EW, Nishihara K. Percutaneous transesophageal gastro-tubing (PTEG) as an alternative long-term tube feeding procedure when gastrostomy is not feasible. Therap Adv Gastroenterol 2017; 10 (12) 911-917
- 50 Sanogo ML, Sherk W, Esparaz A, Marko X, Gemmete JJ, Shields J. Percutaneous transesophageal access for enteral feeding tube placement. Cardiovasc Intervent Radiol 2020; 43 (01) 155-161
- 51 Rotellini-Coltvet L, Wallace A, Saini G. et al. Percutaneous transesophageal gastrostomy (PTEG): an institutional review and largest reported case series in the United States. J Palliat Care Med 2023; 13: 496
- 52 Aramaki T, Arai Y, Takeuchi Y. et al. A randomized, controlled trial of the efficacy of percutaneous transesophageal gastro-tubing (PTEG) as palliative care for patients with malignant bowel obstruction: the JIVROSG0805 trial. Support Care Cancer 2020; 28 (06) 2563-2569
- 53 Hoffer EK, Cosgrove JM, Levin DQ, Herskowitz MM, Sclafani SJ. Radiologic gastrojejunostomy and percutaneous endoscopic gastrostomy: a prospective, randomized comparison. J Vasc Interv Radiol 1999; 10 (04) 413-420
- 54 Hallisey MJ, Pollard JC. Direct percutaneous jejunostomy. J Vasc Interv Radiol 1994; 5 (04) 625-632
- 55 Cope C, Davis AG, Baum RA, Haskal ZJ, Soulen MC, Shlansky-Goldberg RD. Direct percutaneous jejunostomy: techniques and applications -- ten years experience. Radiology 1998; 209 (03) 747-754
- 56 van Overhagen H, Ludviksson MA, Laméris JS. et al. US and fluoroscopic-guided percutaneous jejunostomy: experience in 49 patients. J Vasc Interv Radiol 2000; 11 (01) 101-106
- 57 Brock MV, Venbrux AC, Heitmiller RF. Percutaneous replacement jejunostomy after esophagogastrectomy. J Gastrointest Surg 2000; 4 (04) 407-410
- 58 Martin DF, Laasch HU. Gastroduodenal stenting. Semin Intervent Radiol 2004; 21 (03) 167-179