title: Ultrasound-guided percutaneous 'push-introducer' gastrostomy is a valuable method for accessing the gastrointestinal tract.
abstract: Percutaneous endoscopic gastrostomy (PEG) is the most effective and least invasive method for enteral nutrition (EN). The most common system for PEG is the 'pull' technique, which . It is not available in case endoscopy cannot be performed. The 'push' technique may be an option if effective identification of the abdominal structures can be achieved. X-ray or ultrasonography can be used for that purpose. The aim was to assess the clinical value of ultrasound-guided 'push' gastrostomy. A retrospective analysis of eleven patients (6 F, 5 M, mean age 65.1) including the procedure itself, complication rate, and cost was conducted. In all eleven patients the surgery was successful, and EN was introduced 4-6 hours afterwards. Complications included pain requiring removal of a supporting stitch (n = 1) and balloon deflation (n = 1). All patients were successfully fed enterally. Ultrasound-guided 'push' technique gastrostomy should become a method of choice if the 'pull' method is unavailable.
authors: Stanley Dudrick's Memorial Hospital. General and Oncology Surgery Unit. Skawina. Poland.. klek@poczta.onet.pl.
authors: Stanislaw
authors: S
authors: Klek
authors: Department of Pediatric Surgery. Medical University of Bialystok. Poland.. klek@poczta.onet.pl.
authors: Adam
authors: A
authors: Hermanowicz
authors: Stanley Dudrick's Memorial Hospital. General and Oncology Surgery Unit. Skawina. Poland.. klek@poczta.onet.pl.
authors: Jerzy
authors: J
authors: Salowka
authors: Stanley Dudrick's Memorial Hospital. General and Oncology Surgery Unit. Skawina. Poland.. klek@poczta.onet.pl.
authors: Tomasz
authors: T
authors: Cegielny
authors: Chair of General. Gastroenterology and Oncology and Plastic Surgery. Medical University of Poznan. Poland.. klek@poczta.onet.pl.
authors: Konrad
authors: K
authors: Matysiak
authors: School of Medicine. Aristotle University of Thessaloniki. Greece.. klek@poczta.onet.pl.
authors: Michael
authors: M
authors: Chourdakis
authors: Stanley Dudrick's Memorial Hospital. General and Oncology Surgery Unit. Skawina. Poland.. klek@poczta.onet.pl.
authors: Piotr
authors: P
authors: Szybinski
mesh_terms: D000368:Aged; D004750:Enteral Nutrition / Q000379:methods; D005260:Female; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted / Q000379:methods*; D018084:Ultrasonography, Interventional / Q000379:methods