PERCUTANEOUS FEEDING GASTROSTOMY IN PATIENTS WITH A PARTIAL GASTRECTOMY - TRANSHEPATIC APPROACH WITH CT GUIDANCE

Background: Percutaneous gastrostomy in patients with a partial gastrectomy is rarely performed because the gastric remnants are generally small, positioned high subcostally, and overlaid by the transverse colon and the left lobe of the Liver. Methods: We performed percutaneous transhepatic feeding, gastrostomy in four patients with a partial gastrectomy whose conditions precluded oral feeding. The gastric remnant was punctured with a 22-gauge percutaneous transhepatic cholanioraphy needle through the left lobe of the Liver with computed tomography guidance and following tract dilation over the guidewire 8 or 9F, Cope loop catheters were fluoroscopically placed. Results: No obvious complications were encountered during the procedures. The catheter feedings were continued for 2 to 7 months without any serious problems. Conclusions: We conclude this technique can be performed easily and may be safe because of the presence of the adhesion between the remnant and the liver, which prevents a massive hemorrhage or the displacement of the catheters.