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

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Indian Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

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.

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Authors and Affiliations

  1. Institute of Digestive and Hepatobiliary Sciences, Medanta The Medicity, CH. Baktawar Singh Road, Sector 38, Near Rajiv Chowk, Islampur Colony, Gurgaon, 122 001, India

    Mukesh Nasa, Zubin Dev Sharma, Narendra S. Choudhary, Gaurav Patil, Rajesh Puri & Randhir Sud

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  1. Mukesh Nasa
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  2. Zubin Dev Sharma
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  3. Narendra S. Choudhary
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  4. Gaurav Patil
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  5. Rajesh Puri
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  6. Randhir Sud
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Correspondence to Rajesh Puri.

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Conflict of interest

MN, ZDS, NSC, GP, RP, and RS declare that they have no conflict of interest.

Ethics statement

The authors declare that the study was performed in a manner to conform with the Helsinki Declaration of 1975, as revised in 2000 and 2008 concerning Human and Animal Rights, and the authors followed the policy concerning Informed Consent as shown on Springer.com

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Nasa, M., Sharma, Z.D., Choudhary, N.S. et al. Over-the-scope clip placement for closure of gastrointestinal fistula, postoperative leaks and refractory gastrointestinal bleed. Indian J Gastroenterol 35, 361–365 (2016). https://doi.org/10.1007/s12664-016-0690-8

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  • DOI: https://doi.org/10.1007/s12664-016-0690-8

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