Over-the-scope clip placement for closure of gastrointestinal fistula, postoperative leaks and refractory gastrointestinal bleed

Introduction The over-the-scope clip (OTSC) has been successfully used in the closure of fistula, perforation, dehiscence, and endoscopic hemostasis. We describe our experience with the OTSC application. Methods Between April 2014 and April 2015, seven patients underwent OTSC application. In four pa...

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Bibliographic Details
Published in:Indian journal of gastroenterology 2016-09, Vol.35 (5), p.361-365
Main Authors: Nasa, Mukesh, Sharma, Zubin Dev, Choudhary, Narendra S., Patil, Gaurav, Puri, Rajesh, Sud, Randhir
Format: Article
Language:English
Subjects:
Adult
Aged
Anastomotic Leak - surgery
Digestive System Surgical Procedures - methods
Esophageal Fistula - surgery
Female
Fistula - etiology
Fistula - surgery
Follow-Up Studies
Gastroenterology
Gastrointestinal Hemorrhage - surgery
Gastrostomy - adverse effects
Hepatology
Humans
Male
Medicine
Medicine & Public Health
Middle Aged
Original Article
Skin Diseases - surgery
Stomach Diseases - surgery
Treatment Outcome
Young Adult
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Summary:Introduction The over-the-scope clip (OTSC) has been successfully used in the closure of fistula, perforation, dehiscence, and endoscopic hemostasis. We describe our experience with the OTSC application. Methods Between April 2014 and April 2015, seven patients underwent OTSC application. In four patients, OTSC was applied for the closure of esophageal fistula, one had OTSC closure of persistent gastrocutaneous fistula after percutaneous endoscopic gastrostomy removal, and OTSC was applied in duodenum in two patients, for duodenal Dieulafoy’s lesion after failed conventional endotherapy and massive rebleed in one and duodenal perforation in another. Results All procedures had technical success with no immediate complication related to OTSC application. Patients were followed up for every month with mean duration of follow up 10.2 months. One patient with bronchoesophageal fistula had development of another fistulous opening above the site of OTSC placement, which was successfully closed with another OTSC. One patient had superficial esophageal wall ulcer opposite the OTSC but it healed spontaneously. Conclusion OTSC provided safe and successful closure in a number of settings.
ISSN:0254-8860
0975-0711
DOI:10.1007/s12664-016-0690-8