Abstract No. 540 Feasibility of percutaneous pull-through gastrostomy tube placement utilizing a “single-stick” method

Abstract

To evaluate the safety and feasibility of single-stick percutaneous pull-through gastrostomy tube placement as compared to standard pull-through percutaneous G-tube placement utilizing gastropexy. Retrospective electronic medical records review was conducted of all patients with percutaneous gastrostomy tube placement by interventional radiology at our institution from January 2018 to September 2020. Relevant imaging and procedure techniques were reviewed. Chart review provided data on equipment used in the procedure, indication for G-tube placement, procedure details and time, immediate and long-term complications related to G-tube placement, and dislodgements. 20 French pull-type gastrostomy tubes were utilized in both patient groups under fluoroscopy guidance. 22 patients underwent single-stick pull-through G-tube placement and 32 patients underwent standard G-tube placement utilizing 2 T-fasteners for gastropexy. The average age of patients undergoing single-stick gastrostomy-tube placement was 70.5 years and the average age of the patients undergoing standard gastrostomy-tube placement was 60.9 years. Procedure time was significantly shorter in the patients who underwent single-stick G-tube placement (M = 22.9 minutes, SD = 34.5) compared to the patients who underwent standard G-tube placement with T-fasteners (M = 30.8 minutes, SD = 10.5), P = .019. Fluoroscopy time did not differ significantly in the patients who underwent single-stick G-tube placement (M = 5.87 minutes, SD = 4.29) compared to patients who underwent standard G-tube placement with T-fasteners (M = 7.58 minutes, SD = 6.06), P = .134. No major complications occurred in the single-stick group. Two major complications occurred in the 32 patients that underwent standard G-tube placement (1 left gastric bleed, 1 dislodgement in 3 days). A single-stick method, without the use of gastropexy, appears safe and feasible for placement of percutaneous gastrostomy tubes utilizing the pull through method; with significantly shorter procedure times compared to standard G-tube placement.