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• W3007131158 abstract "Percutaneous gastrojejunostomy (GJ) tubes are a safe and effective option for postpyloric feeding in patients with contraindication to gastric feeding. The most common major complication is retrograde migration of the GJ tube tip into the stomach, resulting in occult (and contraindicated) gastric feeding. The purpose of this study was to identify whether technically modifiable factors during GJ tube insertion are predictive of retrograde tip migration into the stomach. Retrospective review of our procedural database over a 5-year period revealed 988 successful primary GJ tube insertions. Medical records and imaging were reviewed for retrograde tip migration. Analysis was performed on 74 patients with retrograde tip migration within 3 months after placement (37 males, mean age = 57). Comparison was performed on 67 control patients (34 males, mean age = 51) who had radiologic evidence of GJ tube tip stability for at least 6 months. Procedural fluoroscopic images were analyzed for multiple factors, including duodenal bulb and entry point location relative to bony landmarks, tube/tract orientation relative to the pylorus, and length measurements relative to vertebral body width. Predictors of retrograde tip migration were analyzed with univariable and multivariable logistic regression analysis. A total of 110 patients (11.1%) had eventual tip migration, with 74 (7.5%) occurring within 3 months of placement. On univariable analysis, age, GJ insertion site, and tract orientation angle relative to pylorus were significantly associated with tip migration. On multivariable analysis, the only factors associated with a significantly lower risk of tip malposition included gastric puncture site in the antrum (instead of the body) (OR: 0.27, 95% CI: 0.13-0.56, P <0.001) and GJ tract angle less than 30 degrees away from the pylorus (OR: 0.35, 95% CI: 0.16-0.76, P = 0.008). No patient in either cohort had a major complication within 30 days of procedure. For minimization of risk of retrograde tip migration, gastrojejunostomy tubes should be inserted into the gastric antrum with an entry tract oriented as directly towards the pylorus as possible." @default.
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• W3007131158 date "2020-03-01" @default.
• W3007131158 modified "2023-09-26" @default.
• W3007131158 title "Abstract No. 594 Percutaneous gastrojejunostomy tubes: identification of predictors of retrograde tip migration into the stomach" @default.
• W3007131158 doi "https://doi.org/10.1016/j.jvir.2019.12.655" @default.
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