Endoscopic treatment of gastrointestinal fistulas using an over-the-scope clip (OTSC) device: Case series from atertiary referral center

Abstract

Gastrointestinal perforations and post-surgical fistulas are dreaded complications that dramatically increase morbidity and mortality. A new endoscopic over-the-scope clip (OTSC) system may be potentially useful for sealing visceral perforations in several clinical settings.We evaluated the advantages and clinical impact of the placement of OTSCs on the management of non-malignant gut leaks in 12 consecutive patients. OTSCs of 9.5 or 10.5mm were used, according to the diameter of the defect within thewall. The indications for treatment were mainly related to postsurgical fistulas. Healing of the fistula was assessed by endoscopic or radiological means, and failed only once. No OTSC-related complications occurred. Endoscopic closure of perforations and post-surgical fistulas with the OTSC system is asimple and minimally invasive technique. This approach, when feasible, may be less expensive and more advantageous than a surgical approach. © Georg Thieme Verlag KG Stuttgart New York.