Percutaneous Radiologic Gastrostomy Using the One-Anchor Technique in Patients after Partial Gastrectomy

Abstract

ObjectiveThe purpose of our study was to assess the feasibility of performing percutaneous radiologic gastrostomy (PRG) in patients who had undergone partial gastrectomy and to evaluate factors associated with technical success.Materials and MethodsNineteen patients after partial gastrectomy, who were referred for PRG between April 2006 and April 2012, were retrospectively analyzed. The remnant stomach was punctured using a 21-gauge Chiba-needle. A single anchor was used for the gastropexy and a 12-Fr or 14-Fr gastrostomy tube was inserted. Data were collected regarding the technical success, procedure time, and presence of any complications. Univariable analyses were performed to determine the factors related to the technical success.ResultsPercutaneous radiologic gastrostomy was technically successful in 10 patients (53%), while a failed attempt and failure without an attempt were observed in 5 (26%) and 4 (21%) patients, respectively. Percutaneous radiologic jejunostomy was successfully performed in 9 patients who experienced technical failure. In the 10 successful PRG cases, the mean procedure time was 6.35 minutes. Major complications occurred in 2 patients, tube passage through the liver and pneumoperitonum in one and severe hemorrhage in the other. The technical success rate was higher in patients with Billroth I gastrectomy (100%, 6/6) than in patients with Billroth II gastrectomy (31%, 4/13) (p = 0.011).ConclusionPercutaneous radiologic gastrostomy can be successfully performed using the one-anchor technique in approximately half of the patients after partial gastrectomy.

Temporary percutaneous radiologic gastrojejunostomy with single gastropexy

“…Percutaneous endoscopic and radiologic placement of gastrostomy, gastrojejunostomy, and jejunostomy tubes has been a traditionally standard option for nutritional support and enteric feeding for patients with inadequate oral intake (1)(2)(3)(4)(5). Percutaneous jejunostomy or gastrojejunostomy is preferred for patients with an abnormal gastric anatomy or surgically altered stomach (1,6). Since jejunal access using a jejunal tube was first described by Ponsky (7) in 1984, the use of fluoroscopically guided, transgastric jejunostomy, termed percutaneous radiologic gastrojejunostomy (PRGJ), has been increasingly reported as well as very effective for avoiding gastroesophageal reflux or aspiration (7)(8)(9).…”