Ultrasound-guided percutaneous "push-introducer" gastrostomy is a valuable method for accessing the gastrointestinal tract

Abstract

Percutaneous endoscopic gastrostomy (PEG) is the mosteffective and least invasive method for enteral nutrition (EN). The most common system for PEG is the 'pull' technique, which. It is not available in case endoscopy cannot be performed. The 'push' technique may be an option if effective identification of the abdominal structures can be achieved. X-ray or ultrasonography can be used for that purpose. The aim was to assess the clinical value of ultrasound-guided 'push' gastrostomy. A retrospective analysis of eleven patients (6 F, 5 M, mean age 65.1) including the procedure itself, complication rate, and cost was conducted. In all eleven patients the surgery was successful, and EN was introduced 4-6 hours afterwards. Complications included pain requiring removal of a supporting stitch (n = 1) and balloon deflation (n = 1). All patients were successfully fed enterally. Ultrasound-guided 'push' technique gastrostomy should become a method of choice if the 'pull' method is unavailable.

Keywords

• Ultrasonido
• Gastrostomía percutánea
• GEP
• Nutrición enteral