McLoughlin R F, Gibney R G
Department of Diagnostic Imaging, St Vincent's Hospital, Dublin, Ireland.
Abdom Imaging. 1994 May-Jun;19(3):195-200. doi: 10.1007/BF00203505.
We describe our experience with fluoroscopically guided percutaneous gastrostomy, assessing in particular the functional performance of inserted tubes. We also examine the ability of radiological investigations to detect intraperitoneal gastrostomy leakage after the procedure. A functioning gastrostomy tube was established and maintained for as long as was required in 34 (89.5%) of 38 patients referred during a 21-month period. This necessitated further gastrostomy tube placements in 13 patients. On average, inserted gastrostomy tubes functioned for 10.75 weeks and during the review period a total of 34 malfunctioning tubes required replacement or removal. This was most commonly due to tube dislodgement, blockage, or intraperitoneal leakage. We found increasing pneumoperitoneum on sequential postprocedure erect chest films a reliable sign in the diagnosis of the latter complication. In conclusion, while we have been disappointed with aspects of individual tube function, our satisfactory overall functional success rate indicates that percutaneous gastrostomy is an effective method for establishing and maintaining enteral feeding. We also propose a protocol for the management of suspected intraperitoneal leakage based on the findings on postprocedure erect chest films.
我们描述了在透视引导下经皮胃造口术的经验，特别评估了插入胃管的功能表现。我们还检查了放射学检查在术后检测腹腔内胃造口漏的能力。在21个月期间转诊的38例患者中，34例（89.5%）成功建立并在需要的时间内维持了功能正常的胃造口管。这使得13例患者需要再次放置胃造口管。平均而言，插入的胃造口管发挥功能10.75周，在审查期间共有34根功能失常的胃管需要更换或移除。最常见的原因是胃管移位、堵塞或腹腔内漏。我们发现术后连续立位胸片上出现的气腹增加是诊断后一种并发症的可靠征象。总之，虽然我们对个别胃管功能的某些方面感到失望，但我们总体上令人满意的功能成功率表明，经皮胃造口术是建立和维持肠内营养的有效方法。我们还根据术后立位胸片的结果提出了疑似腹腔内漏的处理方案。
