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

  • 1Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
  • 2Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
  • 3Digestive Disease Center, Soonchunhyang University Hospital, Seoul, Korea.
  • 4Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
  • 5Center for Gastric Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
  • 6Department of Gastroenterology, Eulji University School of Medicine, Eulji Hospital, Seoul, Korea.
  • 7Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea.


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.
This was a multicenter prospective study. A total of seven endoscopists at seven centers performed this procedure.
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.
The OTSC system is a safe and effective method for the management of gastrointestinal leakage, especially in cases of anastomotic leakage after surgery.


Over the scope clip; Gastrointestinal leak; Fistula; Perforation
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