Complication Rate of Percutaneous Balloon-Retention versus Locking-Loop Gastrostomy and Gastrojejunostomy Tube Insertion: A Comparison from a Canadian Tertiary Care Centre

Abstract Purpose  The aim of this study is to compare 30-day complications, procedure-related mortality, and overall mortality rates for de novo enteral feeding tube insertion with fluoroscopy-guided percutaneous balloon-retention versus traditional locking-loop tubes. Methods  A retrospective analysis was conducted on adult patients who underwent fluoroscopically guided gastrostomy or gastrojejunostomy tube insertions at two tertiary care centers. We categorized complications based on the Society of Interventional Radiology Standards of Practice for Gastrointestinal Access. Factors including the indication for the procedure, the number of gastropexy anchors, and the tube size were analyzed. Statistical analysis was performed using chi-square tests, and the results were compared with patients who underwent locking loop insertions. Results  A total of 118 patients underwent percutaneous balloon-retention gastrostomy (BRG) or gastrojejunostomy (BRGJ) tube insertions in 2018. These were compared with 559 adult patients who had locking loop insertions at the same institutions from 2011 to 2014. Minor and major complications were higher for the balloon-retention tubes for both BRG (minor: 40.8% vs 4.7%, p  < 0.001; major: 1.4% vs 1.2%, p  = 0.891) and BRGJ tubes (minor: 80.9% vs 11.8%, p  < 0.001; major: 12.8% vs 1.7%, p  < 0.001). Complications were lowest with two gastropexy anchors and highest with three anchors. The 12-F and 14-F balloon-retention tubes had similar complication rates. Although not statistically significant, the balloon-retention tubes were associated with higher procedure-related deaths (1.7% vs 0.7%, p  = 0.300) and all-cause mortality (9.3% vs 5.9%, p  = 0.171). Conclusion  Percutaneous BRG or BRGJ tubes had significantly higher 30-day complication rates. There was no significant difference in the 30-day mortality rate.