[CT-guided percutaneous gastrostomy: success rate, early and late complications].
OBJECTIVE
Percutaneous endoscopic gastrostomy (PEG) and percutaneous radiologic gastrostomy (PRG) are the standard methods of ensuring long-term enteral food intake in patients with dysphagia caused by neoplasia or neurological disorders. High-grade obstructions of the upper digestive tract or inadequate transillumination can prevent PEG. CT-guided percutaneous gastrostomy (PG) represents a special technique for enabling gastrostomy in patients for whom the endoscopic method is impossible. The aim of this study was to evaluate the results and complications of CT-guided percutaneous gastrostomy.


METHODS
CT-guided PG was performed in 83 patients, mostly with malignancy of the upper respiratory or digestive tract. Medical records for these patients were reviewed, and the results and complications of the CT-guided PG were analyzed retrospectively. Complications were grouped into four categories: Major and minor complications as well as early and late complications.


RESULTS
In 95.2 % of all cases (79/83), CT-guided PG was successful in the first attempt. Within the first 3 days, 5 major complications including 4 tube dislocations and one case of peritonitis were found in 4/79 patients (5.1 %). One of these patients experienced two early major complications. Early minor complications, mainly local skin irritations and temporary stomach ache, were observed in 31 patients (39.2 %). Three days after CT-guided PG, 4 cases of major complications were documented, yielding a total rate of major complications was 8.7 % (7/79). Hemorrhage requiring blood transfusion or perforation after gastrostomy was not observed. 29.1 % of the patients (23/79) experienced late minor complications.


CONCLUSIONS
CT-guided percutaneous gastrostomy represents a relatively safe method with a high success rate for enabling gastrostomy in patients with high-grade obstructions of the upper digestive tract or inadequate transillumination. Standard complication classification provides an important basis for quality assessment and disclosure of risks. A classification of complications after gastrostomy is presented for this purpose.
Gottschalk
A
A
Radiologie, Bundeswehrkrankenhaus Ulm, Ulm. andreas.gottschalk@gmx.net
Strotzer
M
M
Feuerbach
S
S
Rogler
G
G
Seitz
J
J
Völk
M
M
D003680:Deglutition Disorders / Q000209:etiology / Q000601:surgery; D004750:Enteral Nutrition; D005260:Female; D005774:Gastrostomy / Q000009:adverse effects* / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D011183:Postoperative Complications / Q000145:classification; D013274:Stomach Neoplasms / Q000601:surgery; D014057:Tomography, X-Ray Computed