IDDF2018-ABS-0015 Over-the-scope clip placement for the closure of gastrointestinal fistula, postoperative leaks and refractory gastrointestinal bleed

Abstract

Background 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 (table 1). In four patients, OTSC was applied for the closure of esophageal fistula (figure 1), 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 a mean duration of follow up 10.2 months. One patient with bronchoesophageal fistula had the 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. Conclusions OTSC provided safe and successful closure in a number of settings such as the closure of fistula, perforation, dehiscence.