Clin Endosc.  2018 Jan;51(1):61-65. 10.5946/ce.2017.027.

Efficacy of the Over-the-Scope Clip System for Treatment of Gastrointestinal Fistulas, Leaks, and Perforations: A Korean Multi-Center Study

• Lee HL
• Cho JY
• Cho JH
• Park JJ
• Kim CG
• Kim SH
• Han JH

• KMID: 2403634
• DOI: http://doi.org/10.5946/ce.2017.027

Abstract

BACKGROUND/AIMS
Currently, a new over-the-scope clip (OTSC) system has been introduced. This system has been used for gastrointestinal perforations and fistulas in other countries. The aim of our study is to examine the therapeutic success rate of endoscopic treatment using the OTSC system in Korea.
METHODS
This was a multicenter prospective study. A total of seven endoscopists at seven centers performed this procedure.
RESULTS
A total of 19 patients were included, with gastrointestinal leakages from anastomosis sites, fistulas, or esophageal perforations due to Boerhaave's syndrome. Among these, there were three gastrojejunostomy sites, three esophagojejunostomy sites, four esophagogastrostomy sites, one esophagocolonostomy site, one jejuno-jejunal site, two endoscopic full thickness resection site closures, one Boerhaave's syndrome, two esophago-bronchial fistulas, one gastrocolonic fistula, and one colonopseudocyst fistula. The size of the leakage ranged from 5 to 30 mm. The median procedure time was 16 min. All cases were technically successful. Complete closure of the leak was achieved in 14 of 19 patients using OTSC alone.
CONCLUSIONS
The OTSC system is a safe and effective method for the management of gastrointestinal leakage, especially in cases of anastomotic leakage after surgery.

Keyword

Over the scope clip; Gastrointestinal leak; Fistula; Perforation

MeSH Terms

Anastomotic Leak
Esophageal Perforation
Fistula*
Gastric Bypass
Humans
Korea
Methods
Prospective Studies

Figure

• 

  Fig. 1. One case of over-the-scope clip (OTSC) procedure. (A, B) About 1 cm sized anastomotic leakage was noted. (C, D) One OTSC placed at the leakage site. (E, F) Endoscopic finding after six months. Only scar lesion was noted.

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