Percutaneous Treatment of a Gastrocutaneous Fistula after Gastrostomy Tube Removal

Postoperative gastric fistula

“…Another common reason for these fistulae stems from leakage of the gastroduodenal or gastrojejunal anastomosis. They may also emerge after removal of long standing gastrostomy tubes, especially in the paediatric population [2]. Finally, the frequency of GFe has recently increased further due to the 0.9 to 3.9% incidence that has been recorded among patients who undergo bariatric surgical procedures [3].…”

“…Classically, it is thought to be secondary to a iatrogenic trauma caused by surgical instrumentation or to arise from a gastroduodenal or gastrojejunal anastomosis as a result of a leak. A long standing gastrostomy tube is yet another common etiologic factor, usually affecting the paediatric population [2]. Bariatric surgery complications have also been implicated [3].…”

Endoscopic-Assisted Closure of Persistent Gastrocutaneous Fistula With a Porcine Fistula Plug: Report of a New Technique

“…4,5 Another technique involves filling of the GC fistula tract with biosynthetic glues, 6 an approach that requires significant endoscopic aptitude and is generally used as an adjuvant to other treatments such as serial tract debridement. 7 In the single published attempt at plugging a GC fistula endoscopically with a collagen plug, the repair failed due to dislodgement of the collagen plug. 8 The technique described here theoretically obviates this problem by confirming placement endoscopically and securing the fistula plug into the subcutaneous tissue adjacent to the fistula tract.…”

Endoscopic fibrin sealing of gastrocutaneous fistulas after sleeve gastrectomy and biliopancreatic diversion with duodenal switch

“…In cases where there is no sign of a tendency to output elimination, the endoscopist should proceed to endoscopic exploration of the anastomotic area. After the identification of an opening, fibrin glue should be applied, as proposed by our team 2,12,14 and by others 18–27 . Attempts of glue sealing of the inner orifice of the GCF should—in our opinion—be repeated in case of no success (with 2–3‐day intervals between them).…”

“…After the identification of an opening, fibrin glue should be applied, as proposed by our team 2,12,14 and by others. [18][19][20][21][22][23][24][25][26][27] Attempts of glue sealing of the inner orifice of the GCF should-in our opinion-be repeated in case of no success (with 2-3-day intervals between them). The point at which gluing should be stopped depends mainly on two parameters: (i) the tendency to closure; and (ii) the experience of the endoscopist in this technique.…”