Preliminary Results of Percutaneous Radiologic Gastrostomy in a Pediatric Population: A Modified Chiba-Needle Puncture Technique With Single Gastropexy.

Abstract

The purpose of this study was to evaluate the technical feasibility, safety, and clinical effectiveness of percutaneous radiologic gastrostomy using a modified Chiba-needle puncture technique with single gastropexy in pediatric patients. From July 2006 to December 2013, percutaneous radiologic gastrostomy was performed in 12 children (median age, 21 months; range, 6-46 months). Their stomachs were punctured using a 21-gauge Chiba needle. A single Cope gastrointestinal suture anchor was used for gastropexy, and a tube was inserted through the same tract as the anchor using a 12- or 14-French Dawson-Mueller pigtail drainage catheter. We then evaluated the technical success of the procedure, the number of puncture attempts using a 21-gauge Chiba needle, the procedure time, complications, and treatment of complications. Percutaneous radiologic gastrostomy was technically successful in all patients. Only a single puncture attempt was required in 10 patients (83%); two attempts were needed in two patients (17%). The average procedure time was 10 minutes 25 seconds (range, 5 minutes 5 seconds to 25 minutes 24 seconds). Pneumoperitoneum requiring tube exchange occurred in two of the 12 patients (17%). Two patients experienced pain immediately after the procedure. Three patients who had esophagogastric reflux after percutaneous radiologic gastrostomy underwent conversion percutaneous radiologic gastrojejunostomy. Percutaneous radiologic gastrostomy using a modified Chiba-needle technique with single gastropexy in pediatric patients is technically feasible and safe.