Combined endoscopic cautery and clip closure of chronic gastrocutaneous fistulas

Teitelbaum, Jonathan E.; Gorcey, Steven; Fox, Victor L.

doi:10.1016/j.gie.2005.04.047

Cited by 39 publications

(22 citation statements)

References 15 publications

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“…5 Gastrocutaneous fistula, which occasionally occurs after removal of a percutaneous gastrostomy tube, also lends itself to endoclip closure. 8,9 In our case, extensive adhesions secondary to the patient's prior Billroth II surgery and chronic cholecystitis resulted in a complex mass involving the hepatic flexure of the colon, the gallbladder, and the duodenal portion of the Billroth II afferent limb. Extensive dissection to free these organs resulted in an injury to the duodenum, which was not successfully repaired and continued to drain bile externally for 2 months through a surgical drain placed in the gallbladder fossa.…”

Section: Discussionmentioning

confidence: 73%

Enterocutaneous Fistula From A Billroth II Afferent Limb: Successful Closure With Endoclips

Voellinger¹

2014

ACGCR

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Recently, indications for endoscopic clips have expanded to include closure of gastrointestinal fistulae and perforations. A 62-year-old man with remote history of surgery for peptic ulcer underwent right hemicolectomy for a large hepatic flexure mass with proximal colonic dilatation. During surgery, inadvertent pinpoint duodenotomy of the afferent Billroth II limb resulted in a duodeno-cutaneous fistula. Despite total parental nutrition, cutaneous bile drainage persisted. The duodenal fistula was closed during upper endoscopy using three endoclips. Cutaneous bile drainage stopped, and the abdominal wall defect healed. This is the first published case of endoclip closure of an iatrogenic duodenal fistula from a Billroth II afferent limb.

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Section: Discussionmentioning

confidence: 73%

Enterocutaneous Fistula From A Billroth II Afferent Limb: Successful Closure With Endoclips

Voellinger¹

2014

ACGCR

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“…26,27 Silver nitrate was used in three cases for endoscopic cauterization of the tracts; the gastrocutaneous fistulas developed after removal of the gastrostomy tubes were closed by clips. 28 Bleeding, anal stricture, recurrence of the fistula, and anal incontinence are the most frequent complications in the surgical treatment of anorectal fistulas. The risk of bleeding is particularly high in deep ischiorectal fistulas.…”

Section: Discussionmentioning

confidence: 99%

Silver Nitrate Cauterization for Anal Fistulas with High Blind Tract Chemical Therapy in Complicated Anal Fistulas

Demırel¹,

Köklü²

2013

Euroasian Journal of Hepato-Gastroenterology

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Aim:The efficiency of a chemical cauterization technique in the treatment of high blind tracts, which are important causes of recurrence in anorectal fistula, were investigated. Materials and methods:Fifteen patients underwent surgery for low perianal fistula with high blind tracts. Partial fistulectomy and cutting seton technique was performed on all patients. The high blind tracts were cauterized by silver nitrate particles and the surgical area was left for secondary healing. The follow-up duration was 6 months to 1 year. The anal continence was evaluated according to the Wexner score.Results: Four of the 15 patients were female, whereas 11 were male. Ages ranged between 17 and 67 years. While 11 participants were primary cases, four were recurrent. Nine of the fistula tracts were intersphincteric and five were transsphincteric and one case had horseshoe fistula. The mean wound healing duration was 5.5 weeks. Mild anal incontinence (Wexner score = 3) was recorded in one case and recurrence was observed in another. Conclusion:Cauterization with silver nitrate is a new treatment method for high blind tract in anal fistulas. It is a safe and noninvasive method that reduces recurrences and surgical complications.

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“…The use of metallic clips has been reported for hemostasis and closure of a perforation caused by various matters. Endoscopic closure by clipping was found to be effective for idiopathic or iatrogenic esophageal perforation [21][22][23]. Rodella [6] reported that endoscopic clipping to close an anastomotic leakage after a gastrectomy was effective and required only a short hospital day.…”

Section: Discussionmentioning

confidence: 99%

Successful endoscopic clipping and application of fibrin glue for an esophago-mediastinal fistula after an esophagectomy

et al. 2011

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A 64-year-old man visited our hospital complaining of abdominal discomfort. A 2-cm-long 0-IIc ? IIa esophageal superficial carcinoma was detected in the middle third of the thoracic esophagus with endoscopy and esophagography. Computed tomography (CT) did not detect any metastasis. The patient underwent videoassisted thoracic surgery of the esophagus (VATS-E). Anastomotic leakage and a thoracic abscess were detected 16 days after the operation. Repeated thoracic drainages and conservative therapy with enteral nutrition were continued for approximately 1 month, but an esophago-mediastinal fistula and small mediastinal cavity remained. Additional drainage using interventional radiology (IVR) reduced the size of the cavity, but could not cure the esophago-mediastinal fistula, 68 days after the operation. The occurrence of an esophago-respiratory fistula followed by a thoracic abscess is a very serious and frequently fatal complication. We performed endoscopic clipping and filling with fibrin glue and succeeded in closing the fistula. Oral intake was started after training in swallowing, and the patient was discharged from hospital 172 days after the operation. One year after the operation he has no sign of a recurrence of the tumor or fistula. We demonstrated a case in which an esophago-mediastinal fistula was successfully repaired by endoscopic clipping with fibrin glue after an operation.

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Combined endoscopic cautery and clip closure of chronic gastrocutaneous fistulas

Cited by 39 publications

References 15 publications

Enterocutaneous Fistula From A Billroth II Afferent Limb: Successful Closure With Endoclips

Enterocutaneous Fistula From A Billroth II Afferent Limb: Successful Closure With Endoclips

Silver Nitrate Cauterization for Anal Fistulas with High Blind Tract Chemical Therapy in Complicated Anal Fistulas

Successful endoscopic clipping and application of fibrin glue for an esophago-mediastinal fistula after an esophagectomy

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