Digestive system
Feeding tubes, abscess drainage, stenting and control of GI bleeding — image-guided care for the digestive system.
OVERVIEW
Dr Marios Agathangelou performs gastrointestinal interventions in Nicosia and Limassol, Cyprus — covered by GESY, €0 for GESY beneficiaries. Gastrointestinal interventions support the digestive system without open surgery: feeding tubes are placed through the skin for nutrition, abscesses are drained, bleeding vessels are embolized, and narrowed segments are held open with stents.
In an emergency, embolization of GI bleeding can be lifesaving; for chronic conditions, these procedures shorten recovery and support quality of life.
WHO IT’S FOR
- Nutritional support needing a feeding tube
- An abdominal abscess or fluid collection
- GI bleeding, or a narrowed oesophagus or bowel
PROCEDURES OFFERED
- Gastrostomy and gastrojejunostomy tube placement
- Percutaneous abscess drainage (liver, spleen, peritoneal)
- GI bleeding embolization
- Esophageal and colorectal stenting
- Portal vein interventions
- Treatment of gastrointestinal fistulas
BENEFITS
GESY COVER
The procedure is fully covered by GESY. It is done as an inpatient admission, and that admission includes the treatment — you pay nothing for the procedure.
Separately, the outpatient visit — the initial assessment, where it is decided whether the treatment suits you — may carry a small co-payment, usually €0–10, as any specialist visit within GESY does.
The co-payment is per activity, and it stops once your total co-payments for the year reach €150 — past that you pay nothing. Some categories of beneficiary have different limits.
Both need a valid referral, from your personal doctor or from a specialist.
Outside GESY, or with private insurance? We provide the documentation your insurer asks for, and a clear cost estimate at your consultation, before you decide anything.
WHAT THESE PROCEDURES SOLVE
Gastrointestinal procedures address specific situations without open surgery: placing a feeding tube when swallowing is not safe, draining an abscess in the abdomen, embolizing a vessel that is bleeding, and stenting a narrowing in the oesophagus or bowel. Some are emergencies and some are planned; this is not one treatment but a set of tools.
A FEEDING TUBE IS A DECISION
Technically, placement is safe and succeeds in the great majority of cases. But the question is rarely technical. Whether a feeding tube is the right step depends on the underlying illness, on what is expected to follow, and on what the person themselves would want. That conversation belongs with the patient where possible, the family and the treating team — not on the radiology table.
RISKS
For most people there is nothing beyond soreness at the entry site for a few days, and a tube that feels strange at first.
The most serious fact in this section is not about a complication. About one patient in ten does not live more than thirty days after a radiologically placed feeding tube. That figure is due mainly to the illness that made the tube necessary, not to the tube itself.
The same figure after endoscopic placement is about one in eighteen. The difference does not mean one method is dangerous and the other safe: in motor neurone disease, where the two were compared in comparable patients, no difference in mortality was found. The radiological route is often chosen precisely when endoscopy is not possible.
Less often: leakage around the tube, inflammation of the skin at the stoma, blockage or displacement. In the motor neurone disease meta-analysis, major complications of radiological placement were under one in a thousand.
Placement succeeds at the first attempt in about 97 cases in 100, a higher rate than the endoscopic route. When it cannot be done, the attempt is stopped and the question goes back to the team looking after you.
For an abscess in the abdomen, catheter drainage succeeds more often than a single needle aspiration, with no more complications and no higher mortality. The difference is about 14 more successes per 100 patients.
Technically, the embolization reaches the bleeding vessel almost every time. Whether the bleeding stops for good is a different question: it does in about three patients in four.
The price of embolization is bowel ischaemia. It affects about five patients in 100 — but where the embolization is done without a located bleeding point, the rate roughly triples. That is why the point is looked for first.
None of these procedures is decided by one doctor. Which one is needed, when, and whether it is needed at all, is judged together with the team looking after you.
COMMON QUESTIONS
Dr Marios Agathangelou, an interventional radiologist, places feeding tubes, drains abscesses and controls GI bleeding in Nicosia and Limassol. It is covered by GESY — €0 for GESY beneficiaries.
Not necessarily. Some are temporary while someone recovers the ability to swallow; others stay. The plan is set with the treating team from the start.
The patient where possible, together with the family and the treating team. Our role is to say whether it can be done safely and how — not whether it should be.
Sometimes, depending on why it was placed and whether swallowing is safe. That is decided by the team assessing your swallowing, not by the tube itself.
A thin tube placed through the skin under imaging to empty a collection of infection, so antibiotics can work and surgery is often avoided.
Yes. Embolizing a bleeding vessel is an emergency procedure and is done as soon as the bleeding point is identified.
It reopens the passage so you can eat or the bowel can work. It does not treat what caused the narrowing — that is managed separately.
Nothing, if you are a GESY beneficiary. GESY covers the procedure in full: it is done as an inpatient admission, and that admission includes the treatment. The outpatient visit where it is decided whether the treatment suits you may carry the usual small GESY co-payment, and you need a valid referral from your personal doctor or from a specialist. Outside GESY, or with private insurance, you get a clear cost estimate at your consultation, before you decide anything.
SOURCES
Clinical statements on this page follow published meta-analyses comparing radiologically and endoscopically inserted gastrostomy, randomised trials of catheter drainage against needle aspiration for abscess, and pooled analyses of embolization for lower gastrointestinal bleeding. They describe these procedures in general; they are not advice about your case.