Safety and effectiveness of percutaneous fluoroscopic gastrostomy in cancer patients.

PURPOSE: To evaluate the safety and effectiveness of percutaneous fluoroscopic gastrostomy (PFG) in cancer patients. METHODS: We retrospectively analyzed the success rate, complication rate, and patient outcomes of PFG performed during a 15-month period in our hospital. The Cope type 10-French and 12-French self-retaining catheters were used for gastrostomy. RESULTS: Of the 113 PFG procedures requested during the study period, 112 (99.1%) were performed successfully; one procedure was cancelled because the nasogastric tube could not be passed through the obstructed esophagus. Thirty-day follow-ups were obtained for 92.0% of the procedures. Of the patients with at least 30 days of follow-up, eight (7.8%) died, but only two deaths (1.9%) were procedure-related. Major complications, including peritonitis and severe wound infection, occurred after eight procedures (7.8%). Minor complications, including superficial wound infection, tube fracture, leakage, severe pain, mild hemorrhage, and tube migration, occurred after 23 procedures (22.3%). The severity of pneumoperitoneum was significantly associated with the frequency of complications (p < 0.05). After placement of the gastrostomy, 68% of the patients maintained or increased their initial body weight; 28% lost 10% or less of their body weight; and 4% lost more than 10% of their body weight. CONCLUSIONS: PFG appears to be effective and relatively safe for long-term nutritional support in cancer patients.

Dynamic MR imaging of hepatolithiasis.

BACKGROUND: To report the dynamic magnetic resonance (MR) imaging findings of hepatolithiasis. METHODS: Dynamic MR images (fast spoiled gradient echo sequence with intravenous injection of gadopentate dimeglumine) and computed tomography, cholangiography, or angiography of nine patients with hepatolithiasis are analyzed. RESULTS: All affected hepatic segments showed atrophic changes and contained dilated intrahepatic ducts. These segments showed either iso- or hypointensity on T1-weighted imaging and hyperintensity on T2-weighted imaging. Preferential enhancement was noted throughout all phases of the dynamic study and persisted to delayed T1-weighted imaging in seven patients. In the last two patients, severe atrophic changes made evaluating signal intensity differences and enhancement patterns difficult. CONCLUSION: In addition to intrahepatic stones and biliary dilatation, segmental atrophy, signal intensity differences, and preferential and persistent enhancement are important MR findings of hepatolithiasis.