Abstract
Background
Percutaneous gastrostomy in patients with a partial gastrectomy is rarely performed because the gastric remnants are generally small, positioned high subcostally, and overlaid by the transverse colon and the left lobe of the liver.
Methods
We performed percutaneous transhepatic feeding gastrostomy in four patients with a partial gastrectomy whose conditions precluded oral feeding. The gastric remnant was punctured with a 22-gauge percutaneous transhepatic cholangiography needle through the left lobe of the liver with computed tomography guidance and following tract dilation over the guidewire 8 or 9F. Cope loop catheters were fluoroscopically placed.
Results
No obvious complications were encountered during the procedures. The catheter feedings were continued for 2 to 7 months without any serious problems.
Conclusions
We conclude this technique can be performed easily and may be safe because of the presence of the adhesion between the remnant and the liver, which prevents a massive hemorrhage or the displacement of the catheters.
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References
Ho CS, Gray RR, Goldfinger M, Rosen IE, McPherson R. Percutaneous gastrostomy for enteral feeding. Radiology 1985;156:349–351
Halkier BK, Ho CS, Yee ACN. Percutaneous feeding gastrostomy with the Seldinger technique: review of 252 patients. Radiology 1989;171:359–362
Hicks ME, Surratt RS, Picus D, Marx MV, Lang EV. Fluoroscopically guided percutaneous gastrostomy and gastroenterostomy: analysis of 158 consecutive cases. AJR 1990;154:725–728
Varney RA, vanSonnenberg E, Casola G, Sukthanker R. Balloon techniques for percutaneous gastrostomy in a patient with a partial gastrectomy. Radiology 1988;167:69–70
Coleman CC, Coons HG, Cope C, et al. Percutaneous enterostomy with the Cope suture anchor. Radiology 1990;174:889–891
Sanchez RB, vanSonnenberg E, D'Agostino HB, Coodacre BW, Moyer P, Casola G. CT guidance for percutaneous gastrostomy and gastroenterostomy. Radiology 1992;184:201–205
Wojtowycz MM, Arata JA Jr, Micklos TJ, Miller FJ Jr. CT findings after uncomplicated percutaneous gastrostomy. AJR 1988;151:307–309
vanSonnenberg E, Wittich GR, Brown LK, et al. Percutaneous gastrostomy and gastroenterostomy: 1. Techniques derived from laboratory evaluation. AJR 1986;146:577–580
Picus D, Marx MV, Weyman PJ. Chronic intestinal obstruction: value of percutaneous gastrostomy tube placement. AJR 1988;150:295–297
Stellato TA, Gauderer MWL. Percutaneous endoscopigastrostomy for gastrointestinal decompression. Ann Surg 1987;205:119–122
Willis JS, Oglesby JT. Percutaneous gastrostomy. Radiology 1988;167:41–43
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Kanazawa, S., Naomoto, Y., Hiraki, Y. et al. Percutaneous feeding gastrostomy in patients with a partial gastrectomy: transhepatic approach with CT guidance. Abdom Imaging 20, 302–306 (1995). https://doi.org/10.1007/BF00203358
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DOI: https://doi.org/10.1007/BF00203358