Feasibility of Percutaneous Radiological Gastrostomy Using the Trocar Technique and 14‑Fr Pigtail Catheter without Gastropexy

Purpose: This study investigates the outcomes of percutaneous radiologic gastrostomy (PRG) using the trocar puncture technique and a 14‑Fr pigtail catheter without gastropexy. Materials and Methods: Retrospective review of the PRG registry (electronic medical records, procedure charts, follow‑up clinical notes, and imaging/interventional procedures) was used to identify patients who underwent PRG using the trocar puncture technique and a 14‑Fr pigtail catheter without gastropexy between January 2015 and April 2021. Technical success, procedure duration, radiation dose, 30‑day mortality, complications, and procedure‑related deaths were evaluated. Results: The PRG success rate in our cohort of 629 patients (566 men, 63 women; average age, 56.5 years) was 99.8% (628/629). Procedure times and radiation doses for the nasogastric, H1 catheter, and direct puncture groups were 27.6, 27.7, and 27.9 min, respectively, and 68, 132.5, and 144.3 mGy, respectively. Periprocedural death occurred in 2 (0.3%) patients. Within 30 days of the procedure, two major complications (0.3%, procedure‑related artery bleeding) and one minor complication (mild fever) occurred. Beyond 30 days of follow‑up, records revealed one abdominal abscess necessitating catheter drainage, 17 (2.7%) tube‑related minor complications, and 30 (4.7%) wound‑related minor complications. Overall, 510 patients died from causes unrelated to PRG, 37 (6.9%) underwent tube removal, and 80 (12.7%) survived with the gastrostomy tube in place. Conclusion: PRG using the trocar puncture technique and a 14‑Fr pigtail catheter without gastropexy is a promising minimally invasive treatment option for gastrostomy. Nonetheless, awareness of the risk factors for periprocedural mortality is critical for selecting the appropriate method for each patient.