Fluoroscopically Guided Percutaneous Gastrostomy in Children

Gastrostomy insertion in children: percutaneous endoscopic or percutaneous image-guided?

“…This corresponds to a superior technical success rate of 97% to 100% reported in literature for the IG technique [9][10][11][12]. Most conversions were because of anatomic difficulties such as scoliosis and high position of the stomach with a narrow subcostal angle, which are more likely to be present in neurologically impaired children.…”

“…For instance, some published reports of minor complications took only wound site problems into account [17], whereas other reports also included delayed feeds and tube-related issues [11,12]. In addition, some patients may experience more than a single complication.…”

Single-Port Laparoscopic Gastrostomy

“…Gastrostomy, as a means for long-term enteral access, is well established in paediatric practice. Options for gastrostomy tube placement include the open method, percutaneous endoscopic gastrostomy (PEG) placement, percutaneous placement under image guidance [3,10], and, most recently, laparoscopic gastrostomy placement [12]. Percutaneous endoscopic gastrostomy [1] has in recent years become the "gold standard" [15] but due to recognised complications [2,7,8,13] alternative minimally invasive methods are being sought.…”

Double-blind randomized clinical trial of percutaneous endoscopic gastrostomy versus radiologically inserted gastrostomy in children

“…One interventional radiologist used glucagon as standard practice, whereas the others used glucagon only when it was difficult to delineate the stomach. RIG was performed using biplane fluoroscopy, with preplacement ultrasonography for localization of the liver. An orogastric snare was passed and the stomach punctured under fluoroscopic guidance with an 18‐G needle, which was used to insert a stiff 0·035‐inch guidewire.…”