Young Chul Cho BS, Presenter: Nothing to Disclose

Ji Hoon Shin MD, Abstract Co-Author: Nothing to Disclose

Ho-Young Song MD, Abstract Co-Author: Nothing to Disclose

Jin Hyoung Kim MD, Abstract Co-Author: Nothing to Disclose

Jung-Hoon Park RT, Abstract Co-Author: Nothing to Disclose

Soo Hwan Kim, Abstract Co-Author: Nothing to Disclose

To evaluate the technical feasibility, safety, and clinical effectiveness of percutaneous radiologic gastrostomy (PRG) in patients who had previously undergone subtotal gastrectomy.

From April 2006 to April 2012, 19 patients were treated with two types of gastric surgery in 13 patients, subtotal gastrectomy with gastrojejunostomy, and in 6 patients, distal gastrectomy with gastroduodenosotmy. PRG procedures with one-anchor technique were attempted and the remnant stomach was punctured with a 21-gauge Chiba-needle, which was exchanged for a 6-Fr Neff catheter. For gastropexy, a single anchor was used and gastrostomy tube placement was performed through the same tract of the anchor with a 12 – 14 F Wills-Oglesby gastrostomy catheter. Technical success rate, cause of technical failure, procedure time, and complications were evaluated and compared between two surgery types.

PRG with the one-anchor technique was performed successfully in 10 (53%) of 19 patients. In nine technical failure, percutaneous radiologic jejunostomy (PRJ) with same procedural technique was performed successfully. Cause of technical failure were small remnant stomach (n=3), high-lying remnant stomach (n=2), and bowels anterior to the stomach (n=4). The average procedure time was 6.35 minutes (PRG) and 13.28 minutes (PRJ). Complications after PRG (n=2) and PRJ (n=0) occurred in two patients involved pneumoperitonum requiring tube removal and massive bleeding requiring embolization. Incidence of technical failure was significantly greater in patients with subtotal gastrectomy with gastrojejunostomy than distal gastrectomy with gastroduodenostomy (6 vs. 0, P = 0.011).

PRG with the one-anchor technique is a technical feasible, safe, and clinical effective in patients with subtotal gastrectomy. PRJ can be alternative option in patients with subtotal gastrectomy with gastrojejunostomy or technical failure of PRG.

PRJ can be more effective method in patients with small remnant stomach, high-lying remnant stomach, and bowels anterior to the stomach than PRG.

Cho, Y, Shin, J, Song, H, Kim, J, Park, J, Kim, S, Percutaneous Radiologic Gastrostomy in Patients with Subtotal Gastrectomy.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13044438.html