title: Percutaneous gastrostomy and gastrojejunostomy after gastric surgery.
abstract: The authors reviewed their experience with percutaneous gastrostomy and gastrojejunostomy in 30 consecutive patients who had undergone prior gastric surgery consisting of either partial resections (n = 24) or alteration of normal gastric anatomy (n = 6). Parameters evaluated included indications for the procedure, procedural modifications, type of prior gastric surgery, major and minor procedural complications, tube efficacy, and follow-up data. Gastrostomy tubes were placed in 27 patients for enteral feeding and in three for decompression. The success rate (100%), as well as the prevalence of major (0%) and minor (23%) morbidity--transient fever, skin infection, and high gastric residuals--were similar to those reported in patients who had not undergone prior gastric surgery. Thirty-day mortality was 13% (four patients); no deaths were related to the gastrostomy tube placement. Minor procedural modifications such as an extra-long needle, a peel-away sheath, or additional rotational fluoroscopy were necessary in 18 patients (60%). Knowledge of the postsurgical gastric anatomy is crucial in this subset of patients. Prior gastric surgery is no longer a contraindication to percutaneous gastrostomy or gastrojejunostomy tube placement.
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110.
authors.forename: S D
authors.initials: SD
authors.lastname: Stevens
authors.forename: D
authors.initials: D
authors.lastname: Picus
authors.forename: M E
authors.initials: ME
authors.lastname: Hicks
authors.forename: M D
authors.initials: MD
authors.lastname: Darcy
authors.forename: T M
authors.initials: TM
authors.lastname: Vesely
authors.forename: M A
authors.initials: MA
authors.lastname: Kleinhoffer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005471:Fluoroscopy; D005743:Gastrectomy; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D007582:Jejunostomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies