Percutaneous fluoroscopic gastrostomy catheter placement: is larger better than small bore?

Aim: To compare the dysfunction and complication rates of small bore and large bore gastrostomy catheters. Material and Methods: A total of 521 patients (291 males, 230 females, mean age 56 years, range 16-90 years) underwent percutaneous fluoroscopic gastrostomy placement between August 2000 and January 2009. Choice of catheter was based on the preference of the Radiologist. Data was collected retrospectively with institutional review board approval. Radiology reports provided clinical history, indication for gastrostomy, information of the catheter, technical success, and immediate outcome. Post procedural complications and clinical outcomes were obtained. Results: All catheters were placed successfully. 15 patients with anatomic difficulties for G tube placement were discarded from the study. Patients who received large bore and small bore catheters were compared. Patients with larger catheters (18F) had fewer short and long term complications and tube dysfunction compared to patients with smaller bore catheters (14F). Discussion and Conclusions: Patients who received small bore gastrostomy catheters were significantly more prone to tube dysfunction. Large bore catheters should be preferred for fewer complications in short and long term.