Complication rates and patency of radiologically guided mushroom gastrostomy, balloon gastrostomy, and gastrojejunostomy: a review of 250 procedures.
OBJECTIVE
To compare complication rates and tube performance of percutaneous mushroom gastrostomy, balloon gastrostomy, and gastrojejunostomy.


METHODS
Between September 9, 1999 and April 23, 2001, 203 patients underwent 250 radiologically guided percutaneous gastrostomy and gastrojejunostomy procedures. Follow-up was conducted through chart reviews and review of our interventional radiology database. Procedural and catheter-related complications were recorded. Chi-square statistical analysis was performed.


RESULTS
In patients receiving mushroom-retained gastrostomy catheters (n = 114), the major complication rate was 0.88% (n = 1), the minor complication rate was 5.3% (n = 6), and the tube complication rate was 4.4% (n = 5). In patients receiving balloon-retained gastrostomy tubes (n = 67), the major complication rate was 0, the minor complication rate was 4.5% (n = 3), and the tube complication rate was 34.3% (n = 23). In patients receiving gastrojejunostomy catheters (n = 69), the major complication rate was 1.4% (n = 1), the minor complication rate was 2.9% (n = 2), and the tube complication rate was 34.8% (n = 24). No statistically significant differences were found between procedural or peri-procedural complications among the different types of tubes. Mushroom-retained catheters had significantly fewer tube complications (p < 0.01).


CONCLUSIONS
Percutaneous gastrostomy and gastrojejunostomy have similar procedural and peri-procedural complication rates. Mushroom gastrostomy catheters have fewer tube-related complications compared with balloon gastrostomy and gastrojejunostomy catheters. In addition, mushroom-retained catheters exhibit the best overall long-term tube patency and are therefore the gastrostomy catheter of choice.
Yip
Doris
D
Department of Radiology, University of Chicago, 5841 S. Maryland Ave MC 2026, Chicago, IL 60637, USA.
Vanasco
Matthew
M
Funaki
Brian
B
D000368:Aged; D002404:Catheterization; D002408:Catheters, Indwelling; D005260:Female; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000628:therapy; D005774:Gastrostomy; D006801:Humans; D007087:Illinois; D007582:Jejunostomy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality; D015641:Radiography, Interventional; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome