Kleven Robert, Ikeda Ian, Cornman-Homonoff Joshua
Department of Radiology and Biomedical Imaging, Yale New Haven Hospital, New Haven, Connecticut.
Department of Radiology and Biomedical Imaging, Section of Interventional Radiology, Yale School of Medicine, New Haven, Connecticut.
Semin Intervent Radiol. 2025 Mar 31;42(1):9-16. doi: 10.1055/s-0045-1806797. eCollection 2025 Feb.
Gastrostomy tubes are a common procedure for interventional radiologists. Several techniques are available to obtain gastric access radiologically, including the antegrade, retrograde, and balloon-assisted techniques. The choice of technique can depend on the patient's clinical presentation and the available services at each institution. Indications, preprocedural workup, technique, and postprocedural care help guide the choice of approach. Three common methods will be reviewed in this article: antegrade, retrograde, and balloon assisted. The antegrade technique is comparable to percutaneous endoscopic gastrostomy placement with a decreased incidence of tube dislodgement compared to the retrograde technique, but it requires reliable oral and esophageal access. The retrograde technique reduces the risk of postprocedural infection, has shorter procedure times, and reduces radiation exposure. The balloon-assisted technique reduces procedure time even more than the antegrade or retrograde technique, with comparable outcomes. Understanding the most common techniques available and how they compare is essential to providing patient-centered care.
胃造口管置入术是介入放射科医生的常见操作。有多种技术可用于通过放射学方法建立胃通路,包括顺行技术、逆行技术和球囊辅助技术。技术的选择可能取决于患者的临床表现以及各机构现有的服务。适应症、术前检查、技术操作和术后护理有助于指导方法的选择。本文将介绍三种常见方法:顺行技术、逆行技术和球囊辅助技术。顺行技术类似于经皮内镜下胃造口术,与逆行技术相比,导管移位的发生率较低,但它需要可靠的口腔和食管通路。逆行技术可降低术后感染风险,手术时间较短,并减少辐射暴露。球囊辅助技术比顺行或逆行技术更能缩短手术时间,且效果相当。了解现有的最常见技术及其比较情况对于提供以患者为中心的护理至关重要。