Computed tomography-gastro-colonography for percutaneous endoscopic gastrostomy using a helical computed tomography.
BACKGROUND
Despite the widespread use of percutaneous endoscopic gastrostomy (PEG) tubes, their placement may be associated with a variety of complications, including gastrocolic fistula.


METHODS
In total, 48 individuals underwent computed tomography-gastro-colonography (CT-GC)-guided PEG placement. Study end points included success of CT-GC, inability to thread the PEG tube, the eventual tube location, tube adjustments needed, adverse events, operating time, and PEG tube-related infection.


RESULTS
A successful CT-GC was achieved in all 48 patients (100%), and we successfully used a standard PEG technique to place the gastrostomy tube in 44 patients (92%). In 4 patients (8%), the laparoscopic-assisted PEG technique was used because the transverse colon became interposed between the abdominal wall and the anterior wall of the stomach. The overall procedure-related minor complication rate was 8%.


CONCLUSIONS
CT-GC is an optional method for the estimation of intra-abdominal, anatomical orientations that may minimize the risk of complications before PEG placement.
Department of Surgery, Pippu Clinic, 2-10, 1 cyome Nakamachi, Pippu, Town Kamikawa-gun, Hokkaido 078-0343, Japan. Electronic address: pippuclinickato@gold.ocn.ne.jp.
Kazuya
K
Kato
Department of Surgery, Asahikawa Medical University, 1-1, 2-1, Midorigaoka, Asahikawa City 078-8510, Japan.
Masahiko
M
Taniguchi
Department of Gastroenterology and Hepatology, Okayama University, 2-5-1, Shikata Town, Okayama City, Okayama 700-8558, Japan.
Yoshiaki
Y
Iwasaki
Department of Surgery, Pippu Clinic, 2-10, 1 cyome Nakamachi, Pippu, Town Kamikawa-gun, Hokkaido 078-0343, Japan.
Keita
K
Sasahara
Department of Surgery, Asahikawa Medical Center, 4048, 7 cyome, Hanasaki-cyo, Asahikawa City 070-8644, Japan.
Atsushi
A
Nagase
Department of Surgery, Hokuyu Hospital, 5-1, 6-6 Higashi-Sappro, Shiroishi-ku, Sapporo City 003-0006, Japan.
Kazuhiko
K
Onodera
Department of Surgery, Nihon University, 1-8-13 Surugadai Kanda, Chiyoda-ku, Tokyo 010-8309, Japan.
Minoru
M
Matsuda
Department of Internal Medicine, Asahikawa Medical University, 1-1, 2-1, Midorigaoka, Asahikawa City 078-8510, Japan.
Yuhei
Y
Inaba
Department of Surgery, Pippu Clinic, 2-10, 1 cyome Nakamachi, Pippu, Town Kamikawa-gun, Hokkaido 078-0343, Japan.
Takako
T
Kawakami
Department of Surgery, Pippu Clinic, 2-10, 1 cyome Nakamachi, Pippu, Town Kamikawa-gun, Hokkaido 078-0343, Japan.
Mineko
M
Higuchi
Department of Radiology, Jikei University, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan.
Yuko
Y
Kobashi
Department of Surgery, Asahikawa Medical University, 1-1, 2-1, Midorigaoka, Asahikawa City 078-8510, Japan.
Hiroyuki
H
Furukawa
D000368:Aged; D000369:Aged, 80 and over; D003106:Colon / Q000000981:diagnostic imaging*; D005240:Feasibility Studies; D005260:Female; D005773:Gastroscopy; D005774:Gastrostomy / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D013270:Stomach / Q000000981:diagnostic imaging*; D025321:Surgery, Computer-Assisted; D036542:Tomography, Spiral Computed
CT-colonography; CT-gastrography; Gastrocolic fistula; Iatrogenic colic perforation; Percutaneous endoscopic gastrostomy