CardioVascular and Interventional Radiology

, Volume 28, Issue 6, pp 692–703 | Cite as

Interventional Radiology Techniques for Provision of Enteral Feeding

REVIEW ARTICLE

Abstract

Gastrostomy placement in patients who are unable to maintain their nutrition orally has been attempted using a variety of techniques over the past century. This includes surgical, endoscopic, and, more recently, percutaneous radiologically guided methods. Surgical gastrostomy placement was the method of choice for almost a century, but has since been superseded by both endoscopic and radiological placement. There are a number of indications for gastrostomy placement in clinical practice today, with fewer contraindications due to the recent innovations in technique placement and gastrostomy catheter type. We describe the technique of gastrostomy placement, which we use in our institution, along with appropriate indications and contraindications. In addition, we will discuss the wide variety of catheter types available and their perceived advantages. There remains some debate with regard to gastropexy performance and the use of primary gastrojejunal catheters, which we will address. In addition, we will discuss the advantages and disadvantages of the three major types of gastrostomy placement currently available (i.e., surgical, endoscopic, and radiological) and their associated complications.

Keywords

Gastrostomy Interventional Radiology Enteral feeding 

References

  1. 1.
    Cosentini ER, Sautner T, Gnant M, et al. (1998) Outcomes of surgical, percutaneous endoscopic and percutaneous radiological gastrostomies. Arch Surg 133:1076–1083CrossRefPubMedGoogle Scholar
  2. 2.
    Gauderer MW, Ponsky JL (1980) Gastrostomy without laparoscopy: a percutaneous endoscopic technique. J Paediatr Surg 15:872–875Google Scholar
  3. 3.
    Preshaw RM, (1981) A percutaneous method for inserting a feeding gastrostomy tube. Surg Gynaecol Obstet 152:659–660Google Scholar
  4. 4.
    Thornton FJ, Fotheringham T, Alexander M, et al. (2002) Amyotrophic lateral sclerosis (ALS): enteral nutrition provision, endoscopic or radiologic gastrostomy? Radiology 224(3):713–717PubMedGoogle Scholar
  5. 5.
    Ho CS, Yeung EY (1992) Percutaneous gastrostomy and transgastric jejunostomy. Am J Roentgenol 158:251–257Google Scholar
  6. 6.
    McLoughlin RF, Ho CS, Gray R. (1996) Fluoroscopically guided percutaneous gastrostomy: current status. Ca. Assoc Radiol. 47:10–15Google Scholar
  7. 7.
    Munk PL, Lee MJ, Poon PY, et al. (1997) Percutaneous gastrostomy in radiologic practice. Austral Radiol 41:342–350Google Scholar
  8. 8.
    McFarland EG, Lee MJ, Boland GW, et al. (1995) Gastropexy breakdown and peritonitis after percutaneous gastrojejunostomy in a patient with ascites. Am J Roentgenol 164:189–193Google Scholar
  9. 9.
    Lee MJ, Saini S, Brink JA, et al. (1991) Malignant small bowel obstruction and ascites: not a contraindication to percutaneous gastrostomy. Clin Radiol 44:332–334CrossRefPubMedGoogle Scholar
  10. 10.
    Mirich DR, Gray RR (1989) Infracolic percutaneous gastrojejunostomy: technical note. Cardiovasc Intervent Radiol 12:340–341PubMedGoogle Scholar
  11. 11.
    Kanazawa S, Naomoto Y, Hiraki Y, et al. (1995) Percutaneous feeding gastrostomy in patients with a partial gastrectomy: Transhepatic approach with CT guidance. Abdom Imaging 20:302–306CrossRefPubMedGoogle Scholar
  12. 12.
    Varney RA, vanSonnenberg E, Giovana C, et al. (1988) Balloon techniques for percutaneous gastrostomy in a patient with partial gastrectomy. Radiology 167:69–70PubMedGoogle Scholar
  13. 13.
    Deurloo EE, Schultze Kool LJ, Kroger R, et al. (2001) Percutaneous radiological gastrostomy in patients with head and neck cancer. Eur J Surg Oncol 27:94–97CrossRefPubMedGoogle Scholar
  14. 14.
    Halkier B, McLoughlin RF, Ho CS (1988) Percutaneous gastrostomy and cystogastrostomy. Semin Intervent Radiol 5:223–229Google Scholar
  15. 15.
    DeBaere T, Chapot R, Kuoch V, et al. (1999) Percutaneous gastrostomy with fluoroscopic guidance: single centre experience in 500 consecutive cancer patients. Radiology 210:651–654PubMedGoogle Scholar
  16. 16.
    Laasch H-U, Wilbraham L, Bullen K, et al. (2003) Gastrostomy insertion: comparing the options—PEG, RIG or PIG. Clin Radiol 58:398–405CrossRefPubMedGoogle Scholar
  17. 17.
    Lyon SM, Haslam PJ, Duke DM, et al. (2003) De novo placement of button gastrostomy catheters in an adult population: experience in 53 patients. J Vasc Intervent Radiol 14(10):1283–1289Google Scholar
  18. 18.
    Trerotola SO, Shah N, Johnson MS, et al. (1998) Single-step dilatation for large bore percutaneous gastrostomy and gastrojejunostomy. J Vasc Intervent Radiol 9:579–582Google Scholar
  19. 19.
    Brown AS, Mueller PR, Ferrucci JT Jr (1986) Controlled percutaneous gastrostomy: Nylon T-Fastener for fixation of the anterior gastric wall. Radiology 158:543–545PubMedGoogle Scholar
  20. 20.
    Saini S, Mueller PR, Gaa J, et al. (1990) Percutaneous gastrostomy with gastropexy: Experience in 125 patients. Am J Roentgenol 154:1003–1006Google Scholar
  21. 21.
    Dewald CL, Hiette PO, Sewall LE, et al. (1999) Percutaneous gastrostomy and gastrojejunostomy with gastropexy: experience in 701 procedures. Radiology 211:651–656PubMedGoogle Scholar
  22. 22.
    Thornton FJ, Fotheringham T, Haslam PJ, et al. (2002) Percutaneous radiological gastrostomy with and without T-Fastener gastropexy: a randomized comparison study. Cardiovasc Intervent Radiol 25(6):467–471CrossRefPubMedGoogle Scholar
  23. 23.
    Ryan JM, Hahn PF, Boland GW, et al. (1997) Percutaneous gastrostomy with T-Fastener gastropexy: results of 316 consecutive procedures. Radiology 203:496–500PubMedGoogle Scholar
  24. 24.
    Deutsch LS, Kannegieter L, Vanson DT, et al. (1992) Simplified percutaneous gastrostomy. Radiology 84:181–183Google Scholar
  25. 25.
    Borge MA, Vesely TM, Picus D (1995) Gastrostomy button placement through percutaneous gastrostomy tracts created with fluoroscopic guidance: experience in 27 children. J Vasc Intervent Radiol 6:179–183Google Scholar
  26. 26.
    Funaki B, Peirce R, Lorenz J, et al. (2001) Comparison of balloon and mushroom retained large bore gastrostomy catheters. Am J Roentgenol 177:359–362Google Scholar
  27. 27.
    McQuaid KR, Little TE (1992). Two fatal complications related to gastrostomy “button” placement. Gastrointest Endosc 38:601–603PubMedGoogle Scholar
  28. 28.
    Shaw AS, Ampong MA, Rio A, et al. (2004) Entristar skin-level gastrostomy tube: primary placement with radiologic guidance in patients with amyotrophic lateral sclerosis. Radiology 233:392–399PubMedGoogle Scholar
  29. 29.
    Szymski GX, Albazzaz AN, Funaki B, et al. (1997) Radiologically guided placement of pull-type gastrostomy tubes. Radiology 205:669–673PubMedGoogle Scholar
  30. 30.
    Halkier BK, Ho CS, Yee ACN (1989) Percutaneous feeding gastrostomy with the Seldinger technique: review of 252 patients. Radiology 171:359–362PubMedGoogle Scholar
  31. 31.
    Lucas CE, Yu P, Vlahos A, et al. (1999) Lower esophageal sphincter dysfunction often precludes safe gastric feeding in stroke patients. Arch. Surg 134:55–58CrossRefPubMedGoogle Scholar
  32. 32.
    Olsen DL, Krubsack AJ, Stewart ET (1993) Percutaneous enteral alimentation: gastrostomy versus gastrojejunostomy. Radiology 187:105–108PubMedGoogle Scholar
  33. 33.
    Hoffer EK, Cosgrove JM, Levin DO, et al. (1999) Radiologic gastrojejunostomy and percutaneous endoscopic gastrostomy: a perspective, randomized comparison. J Vasc Intervent Radiol 10:413–420Google Scholar
  34. 34.
    DiSario JA, Foutch PG, Sanowski RA (1990) Poor results with percutaneous endoscopic jejunostomy. Gastrointest Endosc 36:261–263PubMedGoogle Scholar
  35. 35.
    Gray RR, Ho CS, Yee A, et al. (1987) Direct percutaneous jejunostomy. Am J Roentgenol 149:931–932Google Scholar
  36. 36.
    Cope C, Davis AG, Baum RA, et al. (1998) Direct percutaneous jejunostomy: techniques and applications—ten year experience. Radiology 209:747–754PubMedGoogle Scholar
  37. 37.
    van Overhagen H, Schipper J (2004) Percutaneous jejunostomy. Semin Intervent Radiol 21(3):201–206Google Scholar
  38. 38.
    Hallisey MJ, Pollard JC (1994) Direct percutaneous jejunostomy. J Vasc Intervent Radiol 5:625–632Google Scholar
  39. 39.
    van Overhagen H, Ludviksson MA, Lameris JS, et al. (2000) US and fluoroscopic-guided percutaneous jejunostomy: experience in 49 patients. J Vasc Intervent Radiol 11:101–106Google Scholar
  40. 40.
    Bergstrom LR, Larson DE, Zinsmeister AR, et al. (1995) Utilization and outcomes of surgical gastrostomies and jejunostomies in an era of percutaneous endoscopic gastrostomy: a population based study. Mayo Clin Proc 70:829–836PubMedGoogle Scholar
  41. 41.
    Morris JB, Mullen JL, Yu JC, et al. (1992) Laparoscopic-guided jejunostomy. Surgery 112:96–99PubMedGoogle Scholar
  42. 42.
    Kiely P, Lee MJ (1998) Percutaneous radiological gastrostomy and gastrojejunostomy. J Irish Coll Physicians Surgeons 27:13–16Google Scholar
  43. 43.
    Bell SD, Carmody EA, Yeung EY, et al. (1995) Percutaneous gastrostomy and gastrojejunostomy: additional experience in 519 procedures. Radiology 194:817–820PubMedGoogle Scholar
  44. 44.
    Towbin RB, Ball WS Jr, Bisset GS III. (1988) Percutaneous gastrostomy and percutaneous gastrojejunostomy in chrildren: antegrade approach. Radiology 168:473–476PubMedGoogle Scholar
  45. 45.
    Schneider AM, Loggie BW (1997) Metastatic head and neck cancer to the percutaneous endoscopic gastrostomy exit site: a case report and review of the literature. Am Surg 63:481–486PubMedGoogle Scholar
  46. 46.
    Lee DS, Mohit-Tabatabai MA, Rush BF Jr, et al. (1995) Stomal seeding of head and neck cancer by percutaneous endoscopic gastrostomy tube placement. Ann Surg Oncol 2:462–463PubMedGoogle Scholar
  47. 47.
    Becker G, Hess CF, Grund KE, et al. (1995) Abdominal wall metastasis following percutaneous endoscopic gastrostomy. Support Care Cancer 3: 313–316CrossRefPubMedGoogle Scholar
  48. 48.
    Wollman BS, D’Agostino HB, Walus-Wigle JR, et al. (1995) Radiologic, endoscopic and surgical gastrostomy: an institutional evaluation and meta-analysis of the literature. Radiology 197:699–704PubMedGoogle Scholar
  49. 49.
    Gencosmanoglu R, Koc D, Tozun N (2003) The buried bumper syndrome: migration of internal bumper of percutaneous endoscopic gastrostomy tube into the abdominal wall. J Gastroenterol 38(11):1077–1080CrossRefPubMedGoogle Scholar
  50. 50.
    Vu CK (2002) Buried bumper syndrome: old problem, new tricks. J Gastroentero Hepatol 17(10):1125–1128CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2005

Authors and Affiliations

  1. 1.Department of Academic RadiologyBeaumont HospitalIreland
  2. 2.Royal College of Surgeons in IrelandDublin 2Ireland

Personalised recommendations