Endoscopic closure of gastric tube perforations with titanium clips: a four-case report

Abstract

Perforation of a gastric tube is a rare yet lethal complication after esophagectomy for esophageal cancer treatment. Currently, over-the-scope clip (OTSC) is an effective way to treat gastric tube perforation. Due to the lack of OTSCs, we invented an alternative method composed of a titanium clip and gastroscope. The aim of this study was to describe this novel endoscopic device in the treatment of gastric tube perforation. We used a titanium clip system to treat 4 male patients (range, 53 to 77 years with gastric tube perforation. After the location of the perforation was identified by gastroscope, a titanium endoscopic clip was used to close the perforation. Successful closure of the gastric tube perforation was achieved in three patients while in one patient this failed due to his refusal to undergo reoperation. No postoperative complication was found in the three patients whose perforations were closed and the patient who refused reoperation died due to the reoccurrence of his esophago-cardiac carcinoma. The endoscopic system composed of titanium clip and gastroscope proved to be an efficient and effective device in the treatment of the patients with gastric tube perforations.

Research progress on vascular clips for minimally invasive surgery

“…A large number of clinical trials have shown that, the use of vascular clips as a means of hemostasis in gastric and colorectal polypectomy can effectively prevent postoperative bleeding and digestive tract perforation [12][13][14][15][16][17].…”

A case report of a gastrobronchial fistula and lung abscess caused by leakage from the staple line of a gastric tube after esophagectomy for esophageal cancer

“…Fast-hardening amino acid solution [8] Fibrin glue [6,9] Self-expanding stent [5,10] Dual self-expandable stent [11] Placement of a cardial septal occluder [12] Titanium clips [13]…”