RADIOLOGICALLY GUIDED PLACEMENT OF PULL-TYPE GASTROSTOMY TUBES

PURPOSE: To evaluate percutaneous placement of pull-type gastrostomy t ubes that has traditionally necessitated endoscopic guidance. MATERIAL S AND METHODS: From September 1995 through March 1997, 63 pull-type ga strostomy tubes were placed in 64 patients. Retrograde catheterization of the esophagus was performed through the stomach. Then the gastrost omy tube was pulled through from the mouth into the stomach. RESULTS: Gastrostomy tube placement was successful in 63 (98%) of 64 patients i n 65 attempts. One procedure was stopped when the patient reported che st pain after gastric insufflation, and a second placement attempt was initially unsuccessful. Major complications occurred in three (5%) pa tients: exit site infection necessitating tube removal (n = 2) and pro longed bleeding necessitating transfusion (n = 1). Minor complications occurred in six (9%) patients: failure of placement (n = 2), exit sit e infection (n = 1), leakage around the tube (n = 1), tube migration ( n = 1), and inadvertent tube removal (n = 1). There were no cases of p eritonitis, tract disruption, or gastrostomy-related death. CONCLUSION : Percutaneous placement of a pull-type gastrostomy tube was performed with a minimum risk of tract disruption and peritonitis. The tube was safely and effectively plated by radiologists.