To explore the clinical value of whole CT-guided percutaneous gastrostomy.

From December 2012 to December 2014, we selected a consecutive series of 15 patients who could not receive oral intubation due to esophagus complete obstruction, complicated esophagotracheal fistula or severe heart disease. All of these patients underwent CT-guided gastrostomy, during which the stomach was first punctured using a 21 G Chiba needle and injected with air. The gastric wall was then fixed to the abdominal wall. After successful gastropexy, a channel for gastrostomy was established with a T trocar needle. A balloon tube was advanced via the trocar needle with a peel-away sheath into the gastric lumen and inflated, the peel-away sheath was then removed.

The CT-guided gastrostomy was finished successfully in all of the 15 patients (success rate 100%). The average time of procedure was 31 minutes. During the follow-up period, there were no severe complications such as peritonitis, gastrocolic fistula, and massive bleeding. Minor complications occurred in six patients. Three patients had local infection with severe hyperplasia of granulation tissue around the gastrostomy site, which were cured by local debridement and sterilization; two patients encountered stoma food extravasation, which were treated by changing to a bigger balloon tube (17 G); in one patient, the gastrostomy tube fell out, which was replaced in hospital immediately.

The technique of whole CT-guided percutaneous gastrostomy is of high success rate and minor complications, therefore can be used effectively in clinical settings.

CT guidance; Percutaneous puncture; Gastrostomy