Over-the-scope clip closure of two chronic fistulas after gastric band penetration  

作　　者：Federico Iacopini Nicola Di Lorenzo Fabrizio Altorio Marc-Oliver Schurr Agostino Scozzarro 

机构地区：[1]Gastroenterology and Endoscopy Unit, Ospedale San Giuseppe, Albano Laziale [2]Department of Surgical Science, Policlinico Università di Tor Vergata [3]Steinbeis University Berlin, IHCI-Institute

出　　处：《World Journal of Gastroenterology》2010年第13期1665-1669,共5页世界胃肠病学杂志（英文版）

摘　　要：Gastrointestinal perforations are conservatively managed at endoscopy by through-the-scope endoclips and covered self expandable stents, according to the size and tissue features of the perforation. This is believed to be the first report of successful closure of two gastrocutaneous fistulas with over-the-scope clips (OTSCs). After laparoscopic gastric banding, a 45-year old woman presented with band erosion and penetration. Despite surgical band removal and gastric wall suturing, external drainage of enteric material persisted for 2 wk, and esophagogastroduodenoscopy demonstrated two adjacent 10-mm and 15-mm fistulous orifices at the esophagogastric junction. After cauterization of the margins, the 10-mm fistulous tract was grasped by the OTSC anchor, invaginated into the applicator cap, and closed by a traumatic OTSC. The other 15-mm fistula was too large to be firmly grasped, and a fully-covered metal stent was temporarily placed. No leak occurred during the following 6 wk. At stent removal: the OTSC was completely embedded in hyperplastic overgrowth; the 15-mm fistula significantly reduced in diameter, and it was closed by another traumatic OTSC. After the procedure, no external fistula recurred and both OTSCs were lost spontaneously after 4 wk. The use of the anchor and the OTSC seem highly effective for successful closure of small chronic perforations.Gastrointestinal perforations are conservatively managed at endoscopy by through-the-scope endoclips and covered self expandable stents, according to the size and tissue features of the perforation. This is believed to be the first report of successful closure of two gastrocutaneous fistulas with over-the-scope clips (OTSCs). After laparoscopic gastric banding, a 45-year old woman presented with band erosion and penetration. Despite surgical band removal and gastric wall suturing, external drainage of enter...

关 键 词：Gastrointestinal endoscopy FISTULA STENT Esophagogastric junction 

分 类 号：R656.6[医药卫生—外科学]