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Establishing radiological percutaneous gastrostomy with balloon-retained tubes as an alternative to endoscopic and surgical gastrostomy in patients with tumours of the head and neck or oesophagus

Departments of ¹ Diagnostic Radiology, ² Radiation Oncology and ³ Otolaryngology, Head and Neck Surgery, University of Bern, Inselspital, Freiburgstrasse, CH 3010 Bern, Switzerland

Correspondence: Dr H-P Dinkel, Institut für Diagnostische Radiologie, Inselspital Bern, University of Bern, CH 3010 Bern, Switzerland

The purpose of this study was to report our experience introducing radiological percutaneous gastrostomy (RPG) catheters at a hospital where hitherto only endoscopic and surgical methods have been used. The feasibility, success, time requirements, and complications of RPG were prospectively evaluated during a 12-month period. 26 consecutive patients (median age 63 years, range 41–91 years) underwent gastropexy with T-fasteners followed by insertion of a 12–18 F balloon tube through a peel-away introducer and were followed-up clinically and radiologically. Success and complications occurring within 30 days were assessed. RPG was technically successful in all cases. Median procedure time was 34 min (range 20–90 min), median fluoroscopy time 6.9 min (range 2.3–30 min). 13 surgical gastrostomies were avoided. One minor complication (peristomal leakage) occurred in a patient with gastric reflux and atony. Another patient destroyed the balloon of his tube by injecting food into the balloon port, which led to tube dislocation and peritonitis. In conclusion, radiological gastrostomy can be quickly learned by radiologists and is readily accepted by clinicians. It is an alternative to surgical gastrostomy when percutaneous endoscopic gastrostomy is not feasible, but can also be used as the primary method instead of the endoscopic method.

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