Klinik für Radiologie, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany.
Klinik für Radiologie, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany; Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Straße 2, 10178 Berlin, Germany.
Eur J Radiol. 2022 Jul;152:110333. doi: 10.1016/j.ejrad.2022.110333. Epub 2022 Apr 30.
To investigate the feasibility and complications of computed tomography-guided percutaneous gastroscopy (CT-PG) using two procedural techniques (trocar technique and Seldinger technique) in all patients and in a subgroup of patients with ascites as a relative contraindication.
In this single-center study a total of 233 patients who underwent CT-PG (55 in trocar group and 178 in Seldinger group) between 2012 and 2021 were analyzed retrospectively. Success and complications were determined for both techniques and compared in the total study population and in the subgroup of patients with ascites. Complications were classified using the Common Terminology Criteria for Adverse Events (CTCAE) Protocol for procedural complications.
Feeding tube placement was successful in 93.6% of cases (218/233). In the trocar group, placement was successful in 98.2% (54/55) with a complication rate of 7.4% (4/54) including one grade 5 complication. In the Seldinger group, placement was successful in 92.1% (164/178) with a complication rate of 6.7% but no grade 4 or 5 complication. Preprocedural paracentesis for ascites was performed in 6.9% of patients (16/233). In this subgroup, CT-PG was successful in 87.5% (14/16) and only complications rated as grade 1 or 2 occurred.
CT-PG is a safe interventional procedure, which also applies to patients with ascites if paracentesis is performed beforehand. Specifically, our findings show the Seldinger technique to be safe, as no severe complications occurred in this subgroup.
探讨两种操作技术（套管技术和 Seldinger 技术）在所有患者和腹水作为相对禁忌证的亚组患者中进行 CT 引导经皮胃镜检查（CT-PG）的可行性和并发症。
在这项单中心研究中，回顾性分析了 2012 年至 2021 年间共 233 例接受 CT-PG 的患者（套管组 55 例，Seldinger 组 178 例）。确定了两种技术的成功率和并发症，并在总研究人群和腹水患者亚组中进行了比较。并发症采用程序并发症的常见术语标准（CTCAE）协议进行分类。
93.6%（218/233）的患者成功放置了喂养管。套管组成功率为 98.2%（54/55），并发症发生率为 7.4%（4/54），包括 1 例 5 级并发症。Seldinger 组成功率为 92.1%（164/178），并发症发生率为 6.7%，但无 4 或 5 级并发症。6.9%（233/233）的患者进行了术前腹腔穿刺术。在该亚组中，CT-PG 成功率为 87.5%（14/16），仅发生 1 级或 2 级并发症。
CT-PG 是一种安全的介入治疗方法，如果事先进行腹腔穿刺术，也适用于腹水患者。具体而言，我们的研究结果表明 Seldinger 技术是安全的，因为该亚组未发生严重并发症。
