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Retrospective comparison of outcomes and associated complications between large bore radiologically inserted gastrostomy tube types

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Abstract

Purpose

Multiple approaches to radiologically inserted gastrostomy (RIG) exist. The goal of this study was to compare 30-day outcomes and associated complications between large bore balloon-retained (BR), loop-retained (LR), and pull-type (PT) RIG devices.

Methods

Data on 1477 patients who underwent RIG between January 1, 2005 and December 31, 2016 were collected retrospectively using a dedicated interventional radiology database and electronic medical record. Statistical analysis was performed to compare complication rates between BR, LR, and PT devices.

Results

Ninety-eight percent (1477/1507) of the procedures were successfully performed. A total of 752 BR, 323 LR, and 402 PT gastrostomy tubes were placed. The overall complication rate for BR catheters was 5.7% (25 major [3.3%] and 18 minor [2.4%]). The overall complication rate for PT catheters was 3.7% (8 major [2.0%] and 7 minor [1.7%]). The overall complication rate for LR catheters was 1.6% (4 major [1.4%] and 1 minor [0.8%]). Compared to BR catheters, LR catheters had significantly fewer total complications (P = 0.01) but not minor complications (P = 0.052). There were no significant differences in the number of complications between LR and PT catheters or between BR and PT catheters.

Conclusions

Use of BR, LR, and PT devices for RIG is safe with a low incidence of complications. Compared to BR catheters, primary insertion of a LR gastrostomy was associated with significantly fewer overall complications within the first 30 days. Therefore, for initial tube placement, large bore LR catheters may be preferred over BR devices.

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Abbreviations

BR:

Balloon-retained

LR:

Loop-retained

PT:

Pull-type

RIG:

Radiologically inserted gastrostomy

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Acknowledgements

We would like to thank Ivor Asztalos for help with statistical analyses.

Author information

Authors and Affiliations

  1. Division of Interventional Radiology, Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA, 19104, USA

    David J. Tischfield, Gregory J. Nadolski, Stephen J. Hunt, Maxim Itkin, Richard D. Shlansky-Goldberg & Terence P. Gade

  2. Penn Image-Guided Interventions Laboratory, Perelman School of Medicine at the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA, 19104, USA

    David J. Tischfield, Gregory J. Nadolski, Stephen J. Hunt & Terence P. Gade

  3. Corporal Michael J. Crescenz VA Medical Center, 3900 Woodland Avenue, Bldg 21, Room A422, Philadelphia, PA, 19104, USA

    Stephen J. Hunt & Terence P. Gade

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  1. David J. Tischfield
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Correspondence to Terence P. Gade.

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Conflict of interest

David J. Tischfield has no conflicts of interest. Gregory J. Nadolski reports grants from Guerbet, grants and personal fees from Teleflex, and grants from Lutonix, all outside the scope of the submitted work. Terence P. Gade has no conflicts of interest. Stephen J. Hunt reports personal fees from Amgen and BTG, all outside the scope of the submitted work. Richard D. Shlansky-Goldberg reports grants from BSC, all outside the scope of the submitted work. Maxim Itkin reports grants from Guerbet, all outside the scope of the submitted work.

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Tischfield, D.J., Nadolski, G.J., Hunt, S.J. et al. Retrospective comparison of outcomes and associated complications between large bore radiologically inserted gastrostomy tube types. Abdom Radiol 44, 318–326 (2019). https://doi.org/10.1007/s00261-018-1717-7

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  • DOI: https://doi.org/10.1007/s00261-018-1717-7

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