Non-endoscopic removal of radiologically placed percutaneous primary gastrostomy tubes: a new technique

Abstract

Purpose. To present a new technique for non-endoscopic removal of radiologically inserted primary percutaneous gastrostomy tubes (PGT) and to assess the utility and safety of this technique in the pediatric population. Materials and methods. Over a 9-year period 172 children (80 F, 92 M) mean age 10 years (range 0.29–24 years) underwent removal of radiologically placed PGTs in the Radiology Department. All procedures were performed with conscious sedation. The procedure time ranged from 20 to 45 min (mean 30 min). The procedures were performed electively at ≥ 3 14 months for either gastrostomy button placement (70), balloon gastrostomy and jejunostomy placement (55), or G tube removal at termination of enteral feeding (15). Results. PGT disc retrievals were successful performed in 169 of 173 (98 %). No technical failures occurred, but five procedures failed due to PGT disc lodgement in gastric wall (four), and gastrocolic fistula (one). One child had a repeat procedure due to premature removal of the primary PGT necessitating replacement. No deaths occurred. PGT discs retrieval was performed at a mean time interval of 14 months from initial PGT insertion (range 3–40 months). Conclusion. Non-endoscopic GT disc removal is a quick and safe procedure. It facilitates easy conversion to a gastrostomy button in the radiology setting and avoids the risk of a retained percutaneous gastrostomy tube remnant and intra/transmural migration of discs.