Percutaneous Image-guided Gastrostomy Insertion with and without Gastropexy

Purpose: The objective was to compare the major and minor complications of percutaneous gastrostomy with and without gastropexy. Materials and Methods: This was a retrospective study of adult patients who underwent percutaneous gastrostomy with or without gastropexy between January 2015 and November 2018. A total of 830 patients (512 males [61.8%] and 318 females [38.2%]) were included in the study. Gastropexy was performed for 428 (51.6%) patients (343 pigtail and 85 balloon-type gastrostomies). The remaining 402 patients (48.4%) had no gastropexy (387 pigtail and 15 balloon-type gastrostomies). Major and minor complication rates were assessed within 30 days postprocedure. Results: Technical success was 100% with and without gastropexy. Complications were recorded in 143 patients (17.2%): six major complications in 6 patients and 155 minor complications in 137 patients. Major complications included peritonitis (n = 1) and severe skin infection (n = 1) in the gastropexy group, whereas the remaining four complications were without gastropexy and had tube malposition and peritonitis (n = 4). There was no significant difference in major (0.47% vs. 1%; P = 0.37) or minor complication rate (18.7% vs. 14.2%; P = 0.08) between the gastropexy and nongastropexy groups, respectively. Subgroup analysis showed significantly more superficial infections in the gastropexy group (28 vs. 14; P = 0.04), and pneumoperitoneum was significantly more common with pigtail gastrostomy compared to the balloon-type catheter (30 vs. 0; P = 0.04). There was no significant difference in complication rates in relation to the number of anchors (P = 0.32 for major complications and P = 0.57 for minor complications). Thirty patients (3.6%) died within 30 days after the procedure due to other comorbidities. Conclusion: Gastropexy does not reduce the incidence of major or minor complications following percutaneous gastrostomy and is associated with increased risk for superficial infections. The use of pigtail-type gastrostomy is associated with a higher incidence of pneumoperitoneum.