Percutaneous radiologic gastrostomy: a modified Chiba-needle puncture technique with single gastropexy.
BACKGROUND
To evaluate the feasibility, safety, and effectiveness of percutaneous radiologic gastrostomy (PRG) with a modified Chiba-needle puncture technique with the use of a single gastropexy in the same puncture tract.


METHODS
In 80 patients with dysphagia, the stomach was punctured with a 21-gauge Chiba-needle, which was exchanged for a 6-Fr Neff catheter. Eleven patients with a high-lying stomach and four patients with surgically altered gastric morphology were included. A Cope suture anchor was then deployed into stomach lumens through the Neff catheter to achieve gastropexy. Then, following serial dilation, a 14-Fr diameter locking loop catheter was inserted.


RESULTS
All 80 patients successfully underwent PRG. Only a single puncture attempt was required for 78 patients (98%) and two attempts for two patients each. The average procedure time was 5 min 38 s. Three patients (3.8%) had major complications such as hemorrhage, deep stomal infection, and worsening pneumoperitoneum requiring tube removal. Procedure-related mortality and 30-day mortality was 0% and 5%, respectively.


CONCLUSIONS
PRG with the modified Chiba-needle puncture technique with use of single gastropexy in the same puncture tract was feasible, safe, and effective, especially in patients with high-lying or surgically altered stomachs.
Shin
Ji Hoon
JH
Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. jhshin@amc.seoul.kr
Song
Ho-Young
HY
Kim
Tae-Hyung
TH
Kim
Kyung-Rae
KR
Choi
K Eugene
KE
Kim
Jin Hyoung
JH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D003680:Deglutition Disorders / Q000150:complications*; D005240:Feasibility Studies; D005260:Female; D005774:Gastrostomy / Q000295:instrumentation / Q000379:methods* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles; D011183:Postoperative Complications / Q000401:mortality; D011677:Punctures; D015641:Radiography, Interventional / Q000379:methods*; D013537:Sutures; D016896:Treatment Outcome
D003287:Contrast Media