Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Sep 5;29(5):710-712.
doi: 10.4274/dir.2022.221473. Epub 2023 Jan 11.

Effect of post-pyloric Dobhoff tube retention during gastrojejunostomy for reduction of fluoroscopic time and radiation dose

Tyler S Thompson  1 , Coulter N Small  1 , Hugh Davis  2 , Michael Lazarowicz  2 , Jeffrey Vogel  2 , Robert E Heithaus  1
Affiliations

Effect of post-pyloric Dobhoff tube retention during gastrojejunostomy for reduction of fluoroscopic time and radiation dose

Tyler S Thompson et al. Diagn Interv Radiol. .

Abstract

The purpose of this study was to determine whether retention of a post-pyloric Dobhoff tube (DHT) in position to serve as a visual guide through the pylorus during gastrojejunostomy (GJ) tube placement results in a reduction in fluoroscopy time, procedure time, and estimated radiation dose. A retrospective study evaluated patients who underwent GJ tube placement or gastric to GJ conversion from January 1, 2017, to April 1, 2021. Demographic and procedural data were collected, and results were evaluated using descriptive statistics and hypothesis testing through an unpaired Student's t-test. Of the 71 GJ tube placements included for analysis, 12 patients underwent placement with a post-pyloric DHT in position, and 59 patients underwent placement without a post-pyloric DHT in position. The mean fluoroscopy time and estimated radiation dose were significantly reduced in patients who underwent GJ tube placement with a post-pyloric DHT in position compared with those without (7.08 min vs. 11.02 min, P = 0.004; 123.12 mGy vs. 255.19 mGy, P = 0.015, respectively). The mean total procedure time was also reduced in patients who underwent GJ tube placement with a post-pyloric DHT in position compared with those who had no post-pyloric DHT, but this finding lacked statistical significance (18.55 min vs. 23.15 min; P = 0.09). Post-pyloric DHT retention can be utilized during GJ tube placement to reduce radiation exposure to both the patient and interventionalist.

Keywords: Dobhoff tube; flouroscopy; gastrojejunostomy; radiation; time.

PubMed Disclaimer

Conflict of interest statement

The authors declared no conflicts of interest.

Figures

Figure 1
Figure 1
Initial procedural fluoroscopic imaging confirming the presence of a nasogastric tube in the stomach (dashed arrow), and a Dobhoff tube retained in the distal duodenum (solid arrow).
Figure 2
Figure 2
Procedural fluoroscopic imaging demonstrating successful gastrojejunostomy tube placement (dashed arrow) along a tract parallel to the retained post-pyloric Dobhoff tube (solid arrow).
See this image and copyright information in PMC

References

    1. DiSario JA, Baskin WN, Brown RD, et al. Endoscopic approaches to enteral nutritional support. Gastrointest Endosc. 2002;55(7):901–908. - PubMed
    1. Raha SK, Woodhouse K. The use of percutaneous endoscopic gastrostomy (PEG) in 161 consecutive elderly patients. Age Ageing. 1994;23(2):162–163. - PubMed
    1. Stone B, Hester G, Jackson D, et al. Effectiveness of fundoplication or gastrojejunal feeding in children with neurologic impairment. Hosp Pediatr. 2017;7(3):140–148. - PubMed
    1. DuRocher N, Smith TP, Gazda S, et al. Metoclopramide reduces fluoroscopy and procedure time during gastrojejunostomy tube placement: a placebo-controlled trial. J Vasc Interv Radiol. 2020;31(7):1143–1147. - PubMed
    1. Gupta S, Nihalani ND. Neuroleptic malignant syndrome: a primary care perspective. Prim Care Companion J Clin Psychiatry. 2004;6(5):191–194. - PMC - PubMed

LinkOut - more resources