Percutaneous radiologic gastrostomy: a modified Chiba-needle puncture technique with single gastropexy

Abdom Imaging. 2010 Apr;35(2):189-94. doi: 10.1007/s00261-008-9496-1. Epub 2009 Jan 7.

Abstract

Background: To evaluate the feasibility, safety, and effectiveness of percutaneous radiologic gastrostomy (PRG) with a modified Chiba-needle puncture technique with the use of a single gastropexy in the same puncture tract.

Methods: In 80 patients with dysphagia, the stomach was punctured with a 21-gauge Chiba-needle, which was exchanged for a 6-Fr Neff catheter. Eleven patients with a high-lying stomach and four patients with surgically altered gastric morphology were included. A Cope suture anchor was then deployed into stomach lumens through the Neff catheter to achieve gastropexy. Then, following serial dilation, a 14-Fr diameter locking loop catheter was inserted.

Results: All 80 patients successfully underwent PRG. Only a single puncture attempt was required for 78 patients (98%) and two attempts for two patients each. The average procedure time was 5 min 38 s. Three patients (3.8%) had major complications such as hemorrhage, deep stomal infection, and worsening pneumoperitoneum requiring tube removal. Procedure-related mortality and 30-day mortality was 0% and 5%, respectively.

Conclusions: PRG with the modified Chiba-needle puncture technique with use of single gastropexy in the same puncture tract was feasible, safe, and effective, especially in patients with high-lying or surgically altered stomachs.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Contrast Media
  • Deglutition Disorders / complications*
  • Feasibility Studies
  • Female
  • Gastrostomy / instrumentation
  • Gastrostomy / methods*
  • Gastrostomy / mortality
  • Humans
  • Male
  • Middle Aged
  • Needles*
  • Postoperative Complications / mortality
  • Punctures*
  • Radiography, Interventional / methods*
  • Sutures
  • Treatment Outcome

Substances

  • Contrast Media