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Review
. 2022 Jan;34(1):43-62.
doi: 10.1111/den.14061. Epub 2021 Jul 19.

Current status in endoscopic management of upper gastrointestinal perforations, leaks and fistulas

Shannon Melissa Chan  1 , Kitty Kit Ying Auyeung  1 , Siu Fung Lam  1 , Philip Wai Yan Chiu  1 , Anthony Yuen Bun Teoh  1
Affiliations
Review

Current status in endoscopic management of upper gastrointestinal perforations, leaks and fistulas

Shannon Melissa Chan et al. Dig Endosc. 2022 Jan.

Abstract

Recent advancement in endoscopic closure techniques have revolutionized the treatment of gastrointestinal perforations, leaks and fistulas. Traditionally, these have been managed surgically. The treatment strategy depends on the size and location of the defect, degree of contamination, presence of healthy surrounding tissues, patients' condition and the availability of expertise. One of the basic principles of management includes providing a barricade to the flow of luminal contents across the defect. This can be achieved with a wide range of endoscopic techniques. These include endoclips, stenting, suturing, tissue adhesives and glue, and endoscopic vacuum therapy. Each method has their distinct indications and shortcomings. Often, a combination of these techniques is required. Apart from endoscopic closure, drainage procedures by the interventional radiologist and surgical management also play an important role. In this review article, the outcomes of each of these endoscopic closure techniques in the literature is provided in tables, and practical management algorithms are being proposed.

Keywords: anastomotic leak; fistula; gastrointestinal perforation; wound closure technique.

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References

    1. Panteris V, Haringsma J, Kuipers EJ. Colonoscopy perforation rate, mechanisms and outcome: From diagnostic to therapeutic colonoscopy. Endoscopy 2009; 41: 941-51.
    1. Repici A, Zullo A, Hassan C et al. Endoscopic submucosal dissection of early gastric neoplastic lesions: A western series. Eur J Gastroenterol Hepatol 2013; 25: 1261-4.
    1. Repici A, Hassan C, Carlino A et al. Endoscopic submucosal dissection in patients with early esophageal squamous cell carcinoma: Results from a prospective Western series. Gastrointest Endosc 2010; 71: 715-21.
    1. Repici A, Pellicano R, Strangio G, Danese S, Fagoonee S, Malesci A. Endoscopic mucosal resection for early colorectal neoplasia: Pathologic basis, procedures, and outcomes. Dis Colon Rectum 2009; 52: 1502-15.
    1. Paspatis GA, Arvanitakis M, Dumonceau JM et al. Diagnosis and management of iatrogenic endoscopic perforations: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement - Update 2020. Endoscopy 2020; 52: 792-810.

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