Safety and Feasibility of Ultrasound-Guided Gastric Access for Percutaneous Transabdominal Gastrostomy Tube Placement

Shukla, Pratik A.; Kolber, M.; Tapnio, Richard; Zybulewski, Adam; Kumar, Abhishek; Patel, R.

doi:10.14740/gr1136

Cited by 3 publications

(2 citation statements)

References 17 publications

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“…15,16 A cross-table lateral fluoroscopy image can identify colonic interposition between the stomach and abdominal wall. 30 Fluoroscopy-assisted colonoscopy can be used for moving transverse colon away from the anticipated PEG site in pseudo-obstruction (double-tube technique). 31 PEG site chosen in F-PEG at lower one-third of body of stomach equidistant from greater and lesser curvature lateral to rectus muscle can avoid injury to epigastric or gastroepiploic arteries and might reduce bleeding complications.…”

Section: Discussionmentioning

confidence: 99%

Fluoroscopy-Assisted Percutaneous Endoscopic Gastrostomy (F-PEG)—Single-Center Experience and Outcome

Balekuduru

Bongu

Mandalapu

et al. 2020

Journal of Digestive Endoscopy

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Background Gastrointestinal route is considered for feeding in subjects who are unable to swallow, either as a temporary or permanent option. Percutaneous endoscopic gastrostomy (PEG) is the preferred mode for long-term enteral nutrition. The aim was to study the outcome of protocol-based PEG placement in a tertiary medical center. Materials and Methods All the patients who underwent PEG placement between January 2017 and December 2019 were included in the retrospective study. Study variables were entered into a uniform structured proforma. The procedure was done by two people using Ponsky-Gauderer pull-technique. Fluoroscopy guidance was considered for placement in special situations. Post-procedure, all the patients were regularly followed as per protocol to evaluate for adverse events. Results One hundred and eighteen patients with placement of PEG were included in the study. The mean age of the patients was 49.6 ± 7 years with 67.8% males. The most common indication of PEG was inability to swallow associated with head injury (43, 36.4%), followed by carcinoma esophagus (35, 29.8%) and stroke (24, 20.3%). Fluoroscopy was useful in 38 (32%) for PEG site identification. Tube dislodgement (16, 13.5%) and aspiration pneumonia (20, 16.9%) were the common adverse events. Age more than 60 years and dysphagia in neurologic disorders accounted for more than 60% of adverse events. Forty-nine (42%) of the PEG patients expired due to either primary illness or due to sepsis after a median time of 139 days (range: 32–288 days). There was no difference in the survival in patients with or without PEG-related complications (p = 0. 74). Conclusions Fluoroscopy assistance helps in accurate PEG placement in one third. Age > 60 years and dysphagia in neurologic disorders were independent risk factors associated with PEG tube complications.

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Section: Discussionmentioning

confidence: 99%

Fluoroscopy-Assisted Percutaneous Endoscopic Gastrostomy (F-PEG)—Single-Center Experience and Outcome

Balekuduru

Bongu

Mandalapu

et al. 2020

Journal of Digestive Endoscopy

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“…Abdominal plain X-ray examination after 500 mL of air insufflation into the stomach is a useful method to determine the abdominal puncture point for PEG [20,21] ; however, the position of the transverse colon cannot be determined completely. Although abdominal ultrasound examination under gastrostomy is useful to prevent colocutaneous fistula [22] , this method may not become apparent on the transverse colon. Computed tomography-guided PEG placement is an optional method for the estimation of intraabdominal, anatomical orientations that may minimize the risk of complications [23,24] ; however, CT scan cannot be use under gastrostomy.…”

Section: Protocol For Peg Placementmentioning

confidence: 99%

Prevention of PEG Tube Misplacement in the Transverse Colon: Method of Introducing a Gastrografin into the Stomach

Ono¹,

Yokoyama²,

Yoshida³

et al. 2020

Journal of Gastroenterology and Hepatology Research

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AIM:A colocutaneous fistula is a rare late complication of percutaneous endoscopic gastrostomy (PEG) feeding placement that occurs as a result of the interposition of the colon between the anterior abdominal and gastric walls. In the current study, we sought to retrospectively study the method of introducing the water-soluble contrast agent into the stomach by using a nasogastric tube before PEG feeding placement, with the intention to develop a method to prevent PEG-related colocutaneous fistula. MATERIALS AND METHODS: Between October 2003 and April 2020, 341 patients underwent PEG placement at Seiwa Memorial Hospital. Patients were divided into two groups: 232 patients in Group A were given water-soluble contrast agent and 109 patients in Group B were not. All patients underwent PEG using introducer method placement after gastropexy under fluoroscopy. RESULTS: In Group A, 139 (59.9%) patients received PEG with a water-soluble contrast agent placed into the transverse colon, 75 (32.3%) received PEG with gas in the colon, and 7 (3.0%) patients received surgical gastrostomy. In Group B, 38 (34.8%) patients received PEG with gas in the colon, 60 (55.1%) patients received PEG with finger palpation and transillumination, and 10 (9.2%) patients received surgical gastrostomy. Colocutaneous fistula was not observed in either group, but there was a significant difference in the frequency of surgical gastrostomy between Group A and B (p = 0.0148). CONCLUSION: The use of water-soluble contrast agent in the stomach was safe, reliable, and cost effective for PEG tube placement, and is recommended to decrease surgical gastrostomy.

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Percutaneous Ultrasound-Guided Gastrostomy Placement

Fordyce,

Parikh,

Reis

2024

Recent Strategies in High Risk Surgery

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Safety and Feasibility of Ultrasound-Guided Gastric Access for Percutaneous Transabdominal Gastrostomy Tube Placement

Cited by 3 publications

References 17 publications

Fluoroscopy-Assisted Percutaneous Endoscopic Gastrostomy (F-PEG)—Single-Center Experience and Outcome

Fluoroscopy-Assisted Percutaneous Endoscopic Gastrostomy (F-PEG)—Single-Center Experience and Outcome

Prevention of PEG Tube Misplacement in the Transverse Colon: Method of Introducing a Gastrografin into the Stomach

Percutaneous Ultrasound-Guided Gastrostomy Placement

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