EUS-assisted, fluoroscopically guided gastrostomy tube placement in patients with Roux-en-Y gastric bypass: a novel technique for access to the gastric remnant - 27/08/11
Reprint requests: Rafael S. Andrade, MD, Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, University of Minnesota, 420 Delaware Street SE, MMC 207, Minneapolis, MN 55455Résumé |
Background |
Access to the excluded gastric remnant in patients after Roux-en-Y gastric bypass for gastrostomy tube placement or therapeutic endoscopy is a technical challenge. Available techniques include interventional radiology–placed gastrostomy, deep enteroscopy, and surgical gastrostomy; however, these techniques are hampered by complications, technical complexity, or invasiveness.
Objective |
To describe a novel technique that uses EUS to insufflate the excluded gastric remnant for fluoroscopically guided percutaneous gastrostomy placement.
Design |
Retrospective study.
Setting |
University hospital.
Patients |
Ten patients who required gastrostomy placement after Roux-en-Y gastric bypass.
Interventions |
EUS was used to puncture the excluded stomach through the gastric pouch or jejunum. The stomach was insufflated, and a direct percutaneous gastrostomy placed under fluoroscopic guidance in the distended stomach.
Main Outcome Measurements |
Feasibility, safety, and efficacy of EUS-assisted, fluoroscopically guided gastrostomy tube placement.
Results |
Technical success of EUS-assisted gastrostomy was achieved in 9 of 10 patients(90%). There were no complications.
Limitations |
Single-institution study, small sample size.
Conclusions |
EUS-assisted, fluoroscopically guided gastrostomy tube placement may be a safe and feasible technique to obtain enteral access to the excluded gastric remnant in patients after Roux-en-Y gastric bypass at specialized centers.
Le texte complet de cet article est disponible en PDF.Abbreviations : G-tube, RYGB
Plan
| DISCLOSURE: The authors disclosed no financial relationships relevant to this article. |
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| If you would like to chat with an author of this article, you may contact Dr. Andrade at [email protected]. |
Vol 74 - N° 3
P. 677-682 - septembre 2011 Retour au numéro
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