Endoscopic clipping to prevent papillary obstruction when closing a duodenal perforation with an over-the-scope clip

Abstract

Technique Video Video 1 Placing a standard endoclip at the papillary side of a duodenal perforation is a simple and effective technique for prevention of papillary obstruction when using the over-the-scope clip.

Acute cholangitis after over-the-scope clip placement involving the duodenal papilla that was rescued by antegrade stenting via the percutaneous transhepatic biliary drainage route

“…When closing a fistula of the duodenum, it is often difficult to secure a clear visual field owing to the narrow lumen and edematous mucosa surrounding the lesion. The findings from this case suggest that, when a fistula is located near the duodenal papilla, endoscopists should consider prophylactic measures, such as biliary and pancreatic stenting, or placement of a standard endoclip between the fistula and the duodenal papilla [3]. Endoscopy_UCTN_Code_CPL_1AK_2AI…”