Percutaneous Gastrojejunostomy under Fluoroscopic Guidance: Results from a Single Center in a Cohort of 23 Consecutive Patients 

Authors

  • Rosario Francesco Grasso Department of Radiology, University Campus Bio-Medico of Rome, Via Alvaro del Portillo, 200, 00128 Rome, Italy
  • Roberto Luigi Cazzato Department of Radiology, University Campus Bio-Medico of Rome, Via Alvaro del Portillo, 200, 00128 Rome, Italy
  • Eliodoro Faiella Department of Radiology, University Campus Bio-Medico of Rome, Via Alvaro del Portillo, 200, 00128 Rome, Italy
  • Emiliano Schena Unit of Measurements and Biomedical Instrumentations, Biomedical Engineering Laboratory, University Campus Bio-Medico of Rome, via Alvaro del Portillo, 198, 00128 Rome, Italy
  • Riccardo Del Vescovo Department of Radiology, University Campus Bio-Medico of Rome, Via Alvaro del Portillo, 200, 00128 Rome, Italy
  • Francesco Giurazza Department of Radiology, University Campus Bio-Medico of Rome, Via Alvaro del Portillo, 200, 00128 Rome, Italy
  • Simona Mercurio Department of Radiology, University Campus Bio-Medico of Rome, Via Alvaro del Portillo, 200, 00128 Rome, Italy
  • Giacomo Luppi Department of Radiology, University Campus Bio-Medico of Rome, Via Alvaro del Portillo, 200, 00128 Rome, Italy
  • Bruno Beomonte Zobel Department of Radiology, University Campus Bio-Medico of Rome, Via Alvaro del Portillo, 200, 00128 Rome, Italy

DOI:

https://doi.org/10.12974/2309-6160.2014.02.01.1

Keywords:

Fluoroscopy, Gastro-jejunostomy, Interventional, Percutaneous. 

Abstract

Introduction: to retrospectively investigate technical success, clinical success, complication rate, tube patency and 30-day mortality in a population of patients receiving percutaneous gastro-jejuonostomy (PGJ) under fluoroscopic guidance. Method: Institutional review board was obtained for the present study. Twenty-three patients (11 male, 12 female; mean age 68.3 years, range 37-95 years) were included. Descriptive statistics was used to investigate all variables and tube patency was investigated with Kaplan-Myer plot during a 4-month period. Results: Twenty-three PGJs were placed during a 3-year period in 23 consecutive patients. Technical success for PGJ first placement was reached in 22 patients (95.6%). PGJ exchange was always successful. Clinical success was always reached (100%) after each single procedure. We registered two cases of major complications consistent with bleeding requiring interventions. Minor complications encountered during follow-up were tube clogging and superficial stomal infection. Four-months tube patency was 76.5%. Overall 30-day mortality was 17.4% and 30-day PGJ related mortality was 0%. Conclusion: PGJ under fluoroscopic guidance is a safe and effective procedure with high rates of technical and clinical success coupled to low rates of complications and mortality. 

References

Heinbach DM. Surgical feeding procedures in patients with neurologic disorders. Ann Surg. 1970; 172: 311-314. http://dx.doi.org/10.1097/00000658-197008000-00020

Wilkinson WA, Pickleman J. Feeding gastrostomy: A reappraisal. Am Surg. 1982; 48: 273-275.

Kaplan DS, Murthy UK, Linscheer WG. Percutaneous endoscopic jejunostomy: Long-term follow-up of 23 patients. Gastrointest Endosc. 1989; 35: 403-406. http://dx.doi.org/10.1016/S0016-5107(89)72844-3

Miller RE, Castlemain B, Lacqua FJ, Kotler DP. Percutaneous endoscopic gastrostomy: Results in 316 patients and review of literature. Surg Endosc. 1989; 3: 186-190. http://dx.doi.org/10.1007/BF02171543

Dewald CL, Hiette PO, Sewall LE, Fredenberg PG, Palestrant AM. Percutaneous gastrostomy and gastrojejunostomy with gastropexy: experience in 701 procedures. Radiology. 1999; 211: 651-6. http://dx.doi.org/10.1148/radiology.211.3.r99ma04651

Rosenzweig TB, Palestrant AM, Esplin CA, Gilsdorf RB. A method for radiologic-assisted gastrostomy when percutaneous endoscopic gastrostomy is contraindicated. Am J Surg. 1994; 168: 587-90. http://dx.doi.org/10.1016/S0002-9610(05)80127-8

Barkmeier JM, Trerotola SO, Wiebke EA, et al. Percutaneous radiologic, surgical endoscopic and percutaneous endoscopic gastrostomy/gastrojejunostomy: comparative study and cost analysis. Cardiovasc Intervent Radiol. 1998; 21: 324-8. http://dx.doi.org/10.1007/s002709900269

Mamel JJ. Percutaneous endoscopic gastrostomy. Am J Gastroenterol. 1989; 84: 703-710.

Saini S, Mueller PR, Gaa J, et al. Percutaneous gastrostomy with gastropexy: Experience with 125 patients. AJR. 1990; 154: 1003-1006. http://dx.doi.org/10.2214/ajr.154.5.2108533

Bell SD, Carmody EA, Yeung EY, Thurston WA, Simons ME, Ho CS. Percutaneous gastrostomy and gastrojejunostomy: additional experience in 519 procedures. Radiology. 1995; 194: 817-820.

Hicks ME, Surratt RS, Picus D, Marx MV, Lang EV. Fluoroscopically guided percutaneous gastrostomy and gastroenerostomy: analysis of 158 consecutive cases. AJR. 1990; 154: 725-728. http://dx.doi.org/10.2214/ajr.154.4.2107665

Shin KH, Shin JH, Song HY, Yang ZQ, Kim JH, Kim KR. Primary and conversion percutaneous gastrojejunostomy under fluoroscopic guidance: 10 years of experience. Clin Imaging. 2008; 32: 274-9. http://dx.doi.org/10.1016/j.clinimag.2007.10.023

Giuliano AW, Yoon HC, Lomis NN, Miller FJ. Fluoroscopically guided percutaneous placement of large-bore gastrostomy and gastrojejunostomy tubes: review of 109 cases. J Vasc Interv Radiol. 2000; 11: 239-46. http://dx.doi.org/10.1016/S1051-0443(07)61472-9

Ryan JM, Hahn PF, Boland GW, McDowell RK, Saini S, Mueller PR. Percutaneous gastrostomy with T-fastener gastropexy: results of 316 consecutive procedures. Radiology 1997; 203: 496-500.

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Published

2014-02-05

How to Cite

Grasso, R. F., Cazzato, R. L., Faiella, E., Schena, E., Del Vescovo, R. ., Giurazza, F., Mercurio, S., Luppi, G., & Zobel, B. B. (2014). Percutaneous Gastrojejunostomy under Fluoroscopic Guidance: Results from a Single Center in a Cohort of 23 Consecutive Patients . Global Journal of Oncologists, 2(1), 2–7. https://doi.org/10.12974/2309-6160.2014.02.01.1

Issue

Vol. 2 No. 1 (2014)

Section

Articles