title: Radiologically guided placement of pull-type gastrostomy tubes.
abstract: OBJECTIVE
  To evaluate percutaneous placement of pull-type gastrostomy tubes that has traditionally necessitated endoscopic guidance.
  
  
  METHODS
  From September 1995 through March 1997, 63 pull-type gastrostomy tubes were placed in 64 patients. Retrograde catheterization of the esophagus was performed through the stomach. Then the gastrostomy tube was pulled through from the mouth into the stomach.
  
  
  RESULTS
  Gastrostomy tube placement was successful in 63 (98%) of 64 patients in 65 attempts. One procedure was stopped when the patient reported chest pain after gastric insufflation, and a second placement attempt was initially unsuccessful. Major complications occurred in three (5%) patients: exit site infection necessitating tube removal (n = 2) and prolonged bleeding necessitating transfusion (n = 1). Minor complications occurred in six (9%) patients: failure of placement (n = 2), exit site infection (n = 1), leakage around the tube (n = 1), tube migration (n = 1), and inadvertent tube removal (n = 1). There were no cases of peritonitis, tract disruption, or gastrostomy-related death.
  
  
  CONCLUSIONS
  Percutaneous placement of a pull-type gastrostomy tube was performed with a minimum risk of tract disruption and peritonitis. The tube was safely and effectively placed by radiologists.
authors.affiliation: Department of Radiology, University of Chicago, IL 60637, USA.
authors.forename: G X
authors.initials: GX
authors.lastname: Szymski
authors.forename: A N
authors.initials: AN
authors.lastname: Albazzaz
authors.forename: B
authors.initials: B
authors.lastname: Funaki
authors.forename: J D
authors.initials: JD
authors.lastname: Rosenblum
authors.forename: C A
authors.initials: CA
authors.lastname: Hackworth
authors.forename: B W
authors.initials: BW
authors.lastname: Zernich
authors.forename: J A
authors.initials: JA
authors.lastname: Leef
mesh_terms: D000368:Aged; D004750:Enteral Nutrition / Q000295:instrumentation*; D005260:Female; D005471:Fluoroscopy; D005500:Follow-Up Studies; D005774:Gastrostomy / Q000295:instrumentation*; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D008297:Male; D015641:Radiography, Interventional; D013997:Time Factors