Successful endoscopic closure of iatrogenic duodenal perforation with the new Padlock Clip

Anderloni, Andrea; Bianchetti, Mario G.; Mangiavillano, Benedetto; Fugazza, Alessandro; Leo, Milena Di; Carrara, Sandro; Repici, Alessandro

doi:10.1055/s-0042-124177

Cited by 5 publications

(3 citation statements)

References 6 publications

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“…With recent innovation of the over-the-scope clip (OTSC) by a German group (Ovesco Endoscopy AG, Tubingen, Germany), OTSC nowadays is being used more commonly [8]. Another new innovative padlock clip is also on the horizon and can be used with similar effect without occupying endoscopy channel [9]. To date, the data on the OTSC for scope-induced perforation are scarce.…”

Section: Introductionmentioning

confidence: 99%

Management of scope-induced type I duodenal perforations: Over-the-scope clip versus surgery

Dahale

Srivastava

Saluja

et al. 2021

Indian J Gastroenterol

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Background Scope-induced duodenal perforation is a life-threatening complication and surgery remains the standard of care. With the advent of over-the-scope clip (OTSC), scope-induced perforations are increasingly managed conservatively, though there is no study comparing this form of non-surgical treatment with surgery. We aimed to compare OTSC and surgery in the management of scope-induced perforation of the duodenum. Methods We retrospectively collected data of scope-induced duodenal perforation patients. Perforations identified and treated within 24 h of procedure were analyzed. Factors analyzed were spectrum, etiology, baseline parameters, perforation size, outcome, comorbidities, and duration of hospital stay. Results A total of 25 patients had type I duodenal perforations, out of whom five were excluded due to delayed diagnosis and treatment. Of the twenty, eight were treated with OTSC placement while the rest underwent surgery. Age was comparable and the majority were females. Baseline parameters and comorbidities were similar in both the groups. The median size of perforation was 1.5 cm in both the OTSC group and the surgical group. All patients were treated with standard of care according to institutional protocols. Patients in the OTSC group were started orally after 48 h of OTSC placement, while in the surgery group median time to oral intake was 7 days. Two patients in the surgical group died while there was no mortality in the OTSC group (p = 0.48). Median hospital stay was shorter in the OTSC group (2 days vs. 22 days, p = 0.003). Conclusions OTSC is a feasible and better option in type I duodenal perforations with a shorter hospital stay.

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Section: Introductionmentioning

confidence: 99%

Management of scope-induced type I duodenal perforations: Over-the-scope clip versus surgery

Dahale

Srivastava

Saluja

et al. 2021

Indian J Gastroenterol

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“…It differs from Ovesco in the hexagonal shape and in the deployment system. Clinical data are currently limited, but several case reports describe the successful treatment of tracheoesophageal fistula [ 54 ], gastrocutaneous fistula [ 55 ] and iatrogenic duodenal perforation [ 56 ].…”

Section: Endoscopic Techniquesmentioning

confidence: 99%

Endoscopic Management of Postoperative Esophageal and Upper GI Defects—A Narrative Review

et al. 2023

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Anastomotic defects are deleterious complications after either oncologic or bariatric surgery, leading to high morbidity and mortality. Besides surgical revision in early stages or instable patients, endoscopic treatment has become the mainstay. To date, many options for endoscopic treatment in this setting exist, including fully covered metal stent placement, endoscopic vacuum therapy (EVT), endoscopic internal drainage with pigtail placement (EID), leak closure with through the scope or over the scope clips, endoluminal suturing, fibrin glue sealing and a combination of all these techniques. Current evidence is mostly based on retrospective single and multicenter studies. No guidelines exist in this important field. Treatment options have to be chosen upon each case individually, taking into account clinical and anatomic criteria, such as timing, size, infectious wound complications and hemodynamic stability. Local expertise and availability of treatment devices need to be taken into account whenever choosing a treatment strategy. This review aimed to present current treatment options in terms of effectiveness, advantages and disadvantages in order to guide the clinician for his decision making. Additionally, we aimed to provide a treatment algorithm.

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“…PEG/aspiration devices are currently unavailable on the market; however, the most relevant adverse events related to PEG/aspiration devices are bleeding, wound infection, displacement, buried bumper syndrome, injury to the adjacent viscera, aspiration, leakage, and gastrocutaneous fistula. 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 . Competency in the treatment of these adverse events is necessary for trainees to be competent in the placement of this device should it become available again.…”

Section: Training In Bariatric Endoscopymentioning

confidence: 99%

Curriculum for bariatric endoscopy and endoscopic treatment of the complications of bariatric surgery: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

et al. 2023

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Main recommendationsObesity is a chronic, relapsing, degenerative, multifactorial disease that is associated with many co-morbidities. The global increasing burden of obesity has led to calls for an urgent need for additional treatment options. Given the rapid expansion of bariatric endoscopy and bariatric surgery across Europe, the European Society of Gastrointestinal Endoscopy (ESGE) has recognized the need to formalize and enhance training in bariatric endoscopy and the endoscopic treatment of bariatric surgical adverse events. This manuscript represents the outcome of a formal Delphi process resulting in an official Position Statement of the ESGE and provides a framework to develop and maintain skills in bariatric endoscopy and the endoscopic treatment of bariatric surgical adverse events. This curriculum is set out in terms of the prerequisites prior to training, minimum number of procedures, the steps for training and quality of training, and how competence should be defined and evidenced before independent practice. 1 ESGE recommends that every endoscopist should have achieved competence in upper gastrointestinal endoscopy before commencing training in bariatric endoscopy and the endoscopic treatment of bariatric surgical adverse events. 2 Trainees in bariatric endoscopy and the endoscopic treatment of the complications of bariatric surgery should have basic knowledge of the definition, classification, and social impact of obesity, its pathophysiology, and its related co-morbidities. The recognition and management of gastrointestinal diseases that are more common in patients with obesity, along with participation in multidisciplinary teams where obese patients are evaluated, are mandatory. 3 ESGE recommends that competency in bariatric endoscopy and the endoscopic treatment of the complications of bariatric surgery can be learned by attending validated training courses on simulators initially, structured training courses, and then hands-on training in tertiary referral centers.

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Successful endoscopic closure of iatrogenic duodenal perforation with the new Padlock Clip

Cited by 5 publications

References 6 publications

Management of scope-induced type I duodenal perforations: Over-the-scope clip versus surgery

Management of scope-induced type I duodenal perforations: Over-the-scope clip versus surgery

Endoscopic Management of Postoperative Esophageal and Upper GI Defects—A Narrative Review

Curriculum for bariatric endoscopy and endoscopic treatment of the complications of bariatric surgery: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

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