CT-guided percutaneous gastrostomy: Success rate, early and late complications

Gottschalk, Andreas and Strotzerz, M. and Feuerbach, S. and Rogler, G. and Seitz, J. and Voelk, M. (2007) CT-guided percutaneous gastrostomy: Success rate, early and late complications. ROFO-FORTSCHRITTE AUF DEM GEBIET DER RONTGENSTRAHLEN UND DER BILDGEBENDEN VERFAHREN, 179 (4). pp. 387-395. ISSN 1438-9029,

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Abstract

Purpose: Percutaneous endoscopic gastrostomy (PEG) and percutaneous radiologic gastrostomy (PRG) are the standard methods of ensuring long-term enteral food intake in patients with dysphagia caused by neoplasia or neurological disorders. High-grade obstructions of the upper digestive tract or inadequate transillumination can prevent PEG. CT-guided percutaneous gastrostomy (PG) represents a special technique for enabling gastrostomy in patients for whom the endoscopic method is impossible. The aim of this study was to evaluate the results and complications of CT-guided percutaneous gastrostomy. Materials and Methods: CT-guided PG was performed in 83 patients, mostly with malignancy of the upper respiratory or digestive tract. Medical records for these patients were reviewed, and the results and complications of the CT-guided PG were analyzed retrospectively. Complications were grouped into four categories: Major and minor complications as well as early and late complications. Results: In 95.2% of all cases (79/83), CT-guided PG was successful in the first attempt. Within the first 3 days, 5 major complications including 4 tube dislocations and one case of peritonitis were found in 4/79 patients (5.1 %). One of these patients experienced two early major complications. Early minor complications, mainly local skin irritations and temporary stomachache, were observed in 31 patients (39.2 %). Three days after CT-guided PG, 4 cases of major complications were documented, yielding a total rate of major complications was 8.7% (7/79). Hemorrhage requiring blood transfusion or perforation after gastrostomy was not observed. 29.1 % of the patients (23/79) experienced late minor complications. Conclusion: CT-guided percutaneous gastrostomy represents a relatively safe method with a high success rate for enabling gastrostomy in patients with high-grade obstructions of the upper digestive tract or inadequate transillumination. Standard complication classification provides an important basis for quality assessment and disclosure of risks. A classification of complications after gastrostomy is presented for this purpose.

Item Type: Article
Uncontrolled Keywords: ENDOSCOPIC GASTROSTOMY; RADIOLOGIC GASTROSTOMY; FLUOROSCOPIC GUIDANCE; SURGICAL GASTROSTOMY; TUBE PLACEMENT; NECK-CANCER; GASTROJEJUNOSTOMY; EXPERIENCE; HEAD; GASTROENTEROSTOMY; computed tomography (CT); gastrostomy; percutaneous intervention; early, late, minor, major complications; success rate; nutrition
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Röntgendiagnostik
Depositing User: Dr. Gernot Deinzer
Date Deposited: 21 Dec 2020 09:39
Last Modified: 21 Dec 2020 09:39
URI: https://pred.uni-regensburg.de/id/eprint/33010

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