Usefulness of intragastric observation by utilizing an alley endoscope through a gastric fistula tube made by pericutaneous endoscopic gastrostomy

摘要

We examined the usefulness and safety of intragastric observation by an alley endoscope, which can be inserted through an inner lumen of the gastric fistula tube made by pericutaneous endoscopic gastrostomy, in cases of the tube exchange. After changing the tube of gastric fistula, possibility on detection of tube tip inserted and the observation of the whole stomach mucosa by using the alley endoscope (FB8V, Pentax) with an outer diameter of 2.7 mm was evaluated. In all out of 20 patients, the location of gastric tube bumper was detected by turning over observation technique of intubated endoscope. However, the detailed observation of the whole stomach was difficult due to the leakage of the air, which was inflated through the forceps channel, between the endoscope and the inner lumen of the changed tube, resulting in the insufficient expansion of the stomach. Strategy against the air leakage is necessary in the next step. In conclusion, it is suggested that the observation of the stomach by the alleyendoscope inserted via an inner lumen of the gastric fistula tube during the tube exchange might be useful to safely check the location of the tube tip fixed newly.