Percutaneous gastrostomy and transgastric jejunostomy.

Gastrostomy for feeding or decompression of the stomach or small intestine can be performed by using surgical or percutaneous, nonsurgical techniques. Although use of the surgical technique is well established, recent interest has focused on the nonsurgical methods because of their lower rates of morbidity. Percutaneous gastrostomy by either the endoscopic or the fluoroscopically guided Seldinger technique was introduced in the early 1980s. A number of technical modifications have been described, and sufficient clinical data have been accumulated and published to validate the safety of the percutaneous approach. Several published studies compare surgical with nonsurgical gastrostomy, but none compare the two percutaneous techniques. The purpose of this article is to review the current status of the fluoroscopically guided technique, its indications, and its results and to examine the relative merits of the surgical and nonsurgical techniques.