Fluoroscopically guided percutaneous placement of large-bore gastrostomy and gastrojejunostomy tubes: Review of 109 cases

PURPOSE: To evaluate our experience with percutaneous placement, management , and complications of large-bore (20-24 F) gastrostomy and gastrojejunosto my feeding tubes. MATERIALS AND METHODS: A retrospective review was performed on 109 consecut ive patients who underwent placement of percutaneous large-bore feeding tub es between January 1994 and May 1998, Data were collected with respect to u nderlying illness, technical success, number of replaced tubes, and immedia te and late complications. No patient had a small-bore tube placed during t his series. RESULTS: A total of 109 cases were reviewed. Immediate follow-up within the first 2 weeks was available for all 109, Follow-up after 2 weeks was avail able for 61 (56%) patients. Tubes were placed in patients aged 15 to 94 yea rs. Neurologic dysfunction from a variety of causes was the most common und erlying illness and occurred in 52% of patients. There were nine (8.3%) imm ediate, treatable complications: three major and six minor. There was one p rocedure-related death (0.9%), Persistent fistula tracts following tube rem oval occurred in three patients (4.9%). Balloon rupture was the most common reason for tube exchange (40.7%). CONCLUSION: Percutaneous large-bore gastrostomy and gastrojejunostomy tubes are safe to place and have technical success, morbidity, and mortality rat es comparable to those of tubes placed surgically or endoscopically as well as small-bore tubes placed with fluoroscopic guidance.