PERCUTANEOUS FEEDING GASTROSTOMY IN PATIENTS WITH A PARTIAL GASTRECTOMY - TRANSHEPATIC APPROACH WITH CT GUIDANCE

Background: Percutaneous gastrostomy in patients with a partial gastre ctomy is rarely performed because the gastric remnants are generally s mall, positioned high subcostally, and overlaid by the transverse colo n and the left lobe of the Liver. Methods: We performed percutaneous t ranshepatic feeding, gastrostomy in four patients with a partial gastr ectomy whose conditions precluded oral feeding. The gastric remnant wa s punctured with a 22-gauge percutaneous transhepatic cholanioraphy ne edle through the left lobe of the Liver with computed tomography guida nce and following tract dilation over the guidewire 8 or 9F, Cope loop catheters were fluoroscopically placed. Results: No obvious complicat ions were encountered during the procedures. The catheter feedings wer e continued for 2 to 7 months without any serious problems. Conclusion s: We conclude this technique can be performed easily and may be safe because of the presence of the adhesion between the remnant and the li ver, which prevents a massive hemorrhage or the displacement of the ca theters.