Abstract
Background: Interventional radiology (IR) has played an important role in the technical evolution
of gastrostomy, from the first surgical, endoscopical to percutaneous interventional
procedures. Aim: This study is done to assess the technical feasibility and outcome of IR-guided percutaneous
gastrostomy for patients requiring nutritional support for neuromuscular disorders
or head and neck malignancies, as well as to describe simplified and newer technique
for pull-type gastrostomy. Materials and Methods: This is a retrospective study including 29 patients who underwent IR-guided percutaneous
gastrostomy over a period of 8 years in a tertiary-level institution. Either pull
or push-type gastrostomy was performed in these patients as decided by the interventional
radiologist. The procedures were assessed by analyzing the indications, technical
aspects, and complications. Statistical Analysis: Descriptive summary statistics and frequencies were used to assess the techniques
and related complications. Results: The sample consists of 27 patients (93%) with pull technique and 2 patients (7%)
with push technique. The technical success rate was 100%. Most of the complications
were minor 24% (7/29), including superficial skin infections around the tube site,
self-resolving pneumoperitoneum, tube-related complications such as block, leakage,
deformation, and dislodgement. Three patients (10.3%) had major complications. One
patient (3.4%) developed massive pneumoperitoneum and mild peritonitis due to technical
failure in the first attempt and needed re-puncture for successful placement, and
other two patients (6.9%) developed peristromal focal abscess. One patient died on
the third postoperative day due to type II respiratory failure. Conclusion: IR-guided percutaneous gastrostomy is a safe and effective procedure in selected
patients.
Keywords
Fluoroscopy-guided percutaneous gastrostomy - percutaneous radiological gastrostomy
- per-oral image-guided gastrostomy - pull-type gastrostomy - push-type gastrostomy
