Clark J A, Pugash R A, Pantalone R R
Department of Medical Imaging, University of Toronto, St. Michael's Hospital, Ontario, Canada.
J Vasc Interv Radiol. 1999 Jul-Aug;10(7):927-32. doi: 10.1016/s1051-0443(99)70140-5.
To develop an improved percutaneous technique for the insertion of large-bore gastrostomy tubes.
With use of fluoroscopic guidance, the stomach is punctured and the esophagus is catheterized in a retrograde fashion. A guide wire is passed from the gastrostomy site, up the esophagus, and out of the patient's mouth. A large-bore (20-24 F) endoscopic push-type gastrostomy tube is advanced over the wire, through the mouth, down the esophagus, and out of the gastrostomy site.
Thirty-one successful tube placements were performed in 32 attempts (97% success rate). There were no major procedural or postprocedure complications. Minor complications included one lip laceration (one of 31 = 3%), one minor exit site infection (one of 31 = 3%), and two inadvertent tube dislodgements (two of 31 = 6%).
Radiologic placement of large-bore endoscopic gastrostomy tubes is possible without endoscopy. The procedure is rapid, easy to perform, and safe.
开发一种改良的经皮技术用于插入大口径胃造口管。
在荧光透视引导下，对胃进行穿刺并以逆行方式将食管插入导管。一根导丝从胃造口部位向上穿过食管并从患者口中穿出。一根大口径（20 - 24F）的内镜推送式胃造口管沿导丝推进，经口腔、食管向下并从胃造口部位穿出。
32次尝试中有31次成功置管（成功率97%）。无重大操作或术后并发症。轻微并发症包括1例唇裂伤（31例中的1例 = 3%）、1例轻微出口部位感染（31例中的1例 = 3%）和2例意外的导管移位（31例中的2例 = 6%）。
无需内镜检查即可通过放射学方法放置大口径内镜胃造口管。该操作快速、易于实施且安全。
