Use of an over-the-scope clip for endoscopic sealing of a gastric fistula after sleeve gastrectomy

Abstract

Perforation or development of a fistula in the gastrointestinal tract is a serious complication. A gastrocutaneous fistula after sleeve gastrectomy is difficult to treat, with a mortality rate of 85 % following unsuccessful treatment [1]. These fistulas have been successfully managed with endoscopic fibrin sealing [2]. Preliminary experience with the over-the-scope clipping system (Ovesco, Tubingen, Germany) has shown the efficacy of this intervention in the management of severe bleeding and perforations of the gastrointestinal tract [3] [4] [5].