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Title: CIRSE Standards of Practice Guidelines on Gastrostomy

Abstract

PurposeSurgical Gastrostomy has been around since the 19th century but in 1980 the first successful percutaneous endoscopic gastrostomy was reported. A year later the first successful percutaneous gastrostomy was performed using fluoroscopic guidance. The technique for percutaneous insertion and the equipment used has been refined since then and it is now considered the gold standard for gastrostomy insertion. Here we present guidelines for image-guided enteral feeding tubes in adults.Material and MethodWe performed a review and analysis of the scientific literature, other national and international guidelines and expert opinion.ResultsStudies have shown fluoroscopic techniques have consistently higher success rates with lower rates of major complications than endoscopic techniques. However, the Achilles' heel of many fluoroscopic techniques is the requirement for smaller gastrostomy tube sizes resulting in them being more prone to blockages and thus requiring further intervention.ConclusionRadiological feeding tube insertion is a safe and effective procedure. Success rates are higher, and complication rates lower than PEG or surgical gastrostomy tube placement and innovative techniques for gastric and jejunal access mean that there are very few cases in which RIG is not possible. The principal weakness of radiologically inserted gastrostomies is the limitiation on tube size which leads to a higher rate ofmore » tube blockage. Per-oral image-guided gastrostomies have to an extent addressed this but have not been popularised. Currently many centres still consider endoscopic gastrostomies as the first line unless patients are too unwell to undergo this procedure or previous attempts have failed, in which case radioloically inserted gastrostomies are the technique of choice.« less

Authors:
;  [1];  [2];  [3];  [4];  [1]
  1. Oxford University Hospitals NHS Trust, Radiology Department (United Kingdom)
  2. St. James’s Hospital, Radiology (DiagIm) (Ireland)
  3. Faculty Hospital Charles University, Radiology Department (Czech Republic)
  4. University of Pisa, Diagnostic Imaging and Intervention, Department of Hepatology and Liver Transplants (Italy)
Publication Date:
OSTI Identifier:
22642475
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 39; Journal Issue: 7; Other Information: Copyright (c) 2016 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ADULTS; BIOMEDICAL RADIOGRAPHY; FEEDING; IMAGES; PATIENTS; REVIEWS; STOMACH; SURGERY

Citation Formats

Sutcliffe, James, E-mail: jasutcliffe@gmail.com, Wigham, Andrew, E-mail: a.wigham@doctors.org.uk, Mceniff, Niall, E-mail: nmceniff@stjames.ie, Dvorak, Petr, E-mail: petr-dvorak@email.cz, Crocetti, Laura, E-mail: laura.crocetti@med.unipi.it, and Uberoi, Raman, E-mail: Raman.Uberoi@ouh.nhs.uk. CIRSE Standards of Practice Guidelines on Gastrostomy. United States: N. p., 2016. Web. doi:10.1007/S00270-016-1344-Z.
Sutcliffe, James, E-mail: jasutcliffe@gmail.com, Wigham, Andrew, E-mail: a.wigham@doctors.org.uk, Mceniff, Niall, E-mail: nmceniff@stjames.ie, Dvorak, Petr, E-mail: petr-dvorak@email.cz, Crocetti, Laura, E-mail: laura.crocetti@med.unipi.it, & Uberoi, Raman, E-mail: Raman.Uberoi@ouh.nhs.uk. CIRSE Standards of Practice Guidelines on Gastrostomy. United States. doi:10.1007/S00270-016-1344-Z.
Sutcliffe, James, E-mail: jasutcliffe@gmail.com, Wigham, Andrew, E-mail: a.wigham@doctors.org.uk, Mceniff, Niall, E-mail: nmceniff@stjames.ie, Dvorak, Petr, E-mail: petr-dvorak@email.cz, Crocetti, Laura, E-mail: laura.crocetti@med.unipi.it, and Uberoi, Raman, E-mail: Raman.Uberoi@ouh.nhs.uk. Fri . "CIRSE Standards of Practice Guidelines on Gastrostomy". United States. doi:10.1007/S00270-016-1344-Z.
@article{osti_22642475,
title = {CIRSE Standards of Practice Guidelines on Gastrostomy},
author = {Sutcliffe, James, E-mail: jasutcliffe@gmail.com and Wigham, Andrew, E-mail: a.wigham@doctors.org.uk and Mceniff, Niall, E-mail: nmceniff@stjames.ie and Dvorak, Petr, E-mail: petr-dvorak@email.cz and Crocetti, Laura, E-mail: laura.crocetti@med.unipi.it and Uberoi, Raman, E-mail: Raman.Uberoi@ouh.nhs.uk},
abstractNote = {PurposeSurgical Gastrostomy has been around since the 19th century but in 1980 the first successful percutaneous endoscopic gastrostomy was reported. A year later the first successful percutaneous gastrostomy was performed using fluoroscopic guidance. The technique for percutaneous insertion and the equipment used has been refined since then and it is now considered the gold standard for gastrostomy insertion. Here we present guidelines for image-guided enteral feeding tubes in adults.Material and MethodWe performed a review and analysis of the scientific literature, other national and international guidelines and expert opinion.ResultsStudies have shown fluoroscopic techniques have consistently higher success rates with lower rates of major complications than endoscopic techniques. However, the Achilles' heel of many fluoroscopic techniques is the requirement for smaller gastrostomy tube sizes resulting in them being more prone to blockages and thus requiring further intervention.ConclusionRadiological feeding tube insertion is a safe and effective procedure. Success rates are higher, and complication rates lower than PEG or surgical gastrostomy tube placement and innovative techniques for gastric and jejunal access mean that there are very few cases in which RIG is not possible. The principal weakness of radiologically inserted gastrostomies is the limitiation on tube size which leads to a higher rate of tube blockage. Per-oral image-guided gastrostomies have to an extent addressed this but have not been popularised. Currently many centres still consider endoscopic gastrostomies as the first line unless patients are too unwell to undergo this procedure or previous attempts have failed, in which case radioloically inserted gastrostomies are the technique of choice.},
doi = {10.1007/S00270-016-1344-Z},
journal = {Cardiovascular and Interventional Radiology},
number = 7,
volume = 39,
place = {United States},
year = {Fri Jul 15 00:00:00 EDT 2016},
month = {Fri Jul 15 00:00:00 EDT 2016}
}