Percutaneous gastric remnant gastrostomy following Roux-en-Y gastric bypass surgery: a single tertiary center's 13-year experience

Authors

Shehbaz H. Shaikh, Henry Ford HealthFollow
Justin J. Stenz, Henry Ford Health
David W. McVinnie, Henry Ford HealthFollow
James J. Morrison, Henry Ford Health
Todd Getzen, Henry Ford HealthFollow
Arthur M. Carlin, Henry Ford HealthFollow
Farhaan R. Mir, Henry Ford Health

Recommended Citation

Shaikh SH, Stenz JJ, McVinnie DW, Morrison JJ, Getzen T, Carlin AM, and Mir FR. Percutaneous gastric remnant gastrostomy following Roux-en-Y gastric bypass surgery: a single tertiary center's 13-year experience. Abdom Radiol (NY) 2018 Jun;43(6):1464-1471.

Document Type

Article

Publication Date

6-1-2018

Publication Title

Abdom Radiol (NY)

Abstract

PURPOSE: The purpose of the study is to evaluate the indications, techniques, and outcomes for percutaneous gastrostomy placement in the gastric remnant following Roux-en-Y gastric bypass (RYGB) in bariatric patients.

MATERIALS AND METHODS: Retrospective chart review and summary statistical analysis was performed on all RYGB patients that underwent attempted percutaneous remnant gastrostomy placement at our institution between April 2003 and November 2016.

RESULTS: A total of 38 patients post-RYGB who underwent gastric remnant gastrostomy placement were identified, 32 women and 6 men, in which a total of 41 procedures were attempted. Technical success was achieved in 39 of the 41 cases (95%). Indications for the procedure were delayed gastric remnant emptying/biliopancreatic limb obstruction (n = 8), malnutrition related to RYGB (n = 17), nutritional support for conditions unrelated to RYGB (n = 15), and access for endoscopic retrograde cholangiopancreatography (ERCP, n = 1). Insufflation of the gastric remnant was performed via a clear window (n = 35), transhepatic (n = 5), and transjejunal (n = 1) routes. Five complications were encountered. The four major complications (9.8%) included early tube dislodgement with peritonitis, early tube dislodgement requiring repeat intervention, intractable pain, and upper gastrointestinal bleeding. A single minor complication occurred (2.4%), cellulitis.

CONCLUSION: Patients with a history of RYGB present a technical challenge for excluded gastric remnant gastrostomy placement. As the RYGB population increases and ages, obtaining and maintaining access to the gastric remnant is likely to become an important part of interventional radiology's role in the management of the bariatric patient.

PubMed ID

28929218

Volume

43

Issue

6

First Page

1464

Last Page

1471