SIR 2024
Gastrointestinal Interventions
Sean Lee, BA
Medical Student
Touro College
Financial relationships: Full list of relationships is listed on the CME information page.
A single-center retrospective review of all fluoroscopically-guided percutaneous gastrostomy tube insertions from July 2017-September 2020 was performed. 273 patients were included in this study, with 183 patients and 90 patients in the BAG and dilator groups, respectively. Fluoroscopy time, peak radiation dose, pain management, days to IR reconsultation, and postoperative complications (major and minor) for each procedure were reviewed to evaluate for statistical differences.
Results:
There were shorter fluoroscopy times (5.13 min versus 7.05 min, p=0.059) and a significantly lower radiation use (Avg = 102.13 mGy versus 146.98 mGy, p< 0.05) in the BAG group. The BAG group required significantly lower operating time (41 min versus 48 min, p < 0.01) and received lower pain management (fentanyl 75 mcg and midazolam 1.5mg, p < 0.001). Mean days to IR reconsultation for the BAG group was greater ( 29 days vs 26 days, p=0.38). The overall rate of minor complications (grades 1 and 2, according to the CIRSE classification system) was higher in the dilator group (39% versus 35% in BAG group, p=0.53). No major complications were reported in either group.
Conclusion:
Balloon-assisted gastrostomy is a safe and efficient technique for percutaneous gastrostomy tube placement. BAG patients required significantly lesser radiation, OR time, postoperative pain management, and recorded lower postoperative complications compared to their counterparts in gastrostomies utilizing dilators.