Percutaneous feeding gastrostomy in patients with a partial gastrectomy: transhepatic approach with CT guidance.
BACKGROUND
Percutaneous gastrostomy in patients with a partial gastrectomy is rarely performed because the gastric remnants are generally small, positioned high subcostally, and overlaid by the transverse colon and the left lobe of the liver.


METHODS
We performed percutaneous transhepatic feeding gastrostomy in four patients with a partial gastrectomy whose conditions precluded oral feeding. The gastric remnant was punctured with a 22-gauge percutaneous transhepatic cholangiography needle through the left lobe of the liver with computed tomography guidance and following tract dilation over the guidewire 8 or 9F. Cope loop catheters were fluoroscopically placed.


RESULTS
No obvious complications were encountered during the procedures. The catheter feedings were continued for 2 to 7 months without any serious problems.


CONCLUSIONS
We conclude this technique can be performed easily and may be safe because of the presence of the adhesion between the remnant and the liver, which prevents a massive hemorrhage or the displacement of the catheters.
Kanazawa
S
S
Department of Radiology, Okayama University Medical School, Japan.
Naomoto
Y
Y
Hiraki
Y
Y
Yasui
K
K
Matsuno
T
T
D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization / Q000295:instrumentation; D002758:Cholangiography / Q000295:instrumentation; D004386:Duodenum; D004750:Enteral Nutrition / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D016629:Esophagectomy; D005240:Feasibility Studies; D005471:Fluoroscopy; D005743:Gastrectomy; D005774:Gastrostomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D006801:Humans; D007583:Jejunum; D008099:Liver; D008297:Male; D008875:Middle Aged; D009339:Needles; D011677:Punctures; D015641:Radiography, Interventional; D012449:Safety; D014057:Tomography, X-Ray Computed