Endoscopic hole and clipping technique: a novel technique for closing the wide orifice of a postoperative fistula.

BACKGROUND

Endoscopic clipping for closing a fistula created by surgery is often difficult because of the combination of a wide orifice and fibrosis. Creating holes for prongs of a clip may constitute a new endoscopic clipping technique for closing the wide orifice of a fistula.

OBJECTIVE

To assess the feasibility of performing the endoscopic hole and clipping technique (EHCT).

DESIGN

Experimental pilot study.

SETTING

Tertiary-care referral center.

PATIENT: This study involved 1 patient who underwent EHCT.

INTERVENTIONS: EHCT was performed.

MAIN OUTCOME MEASUREMENTS: Technical success and procedural complications of EHCT.

RESULTS

Immediately after the procedure, drainage decreased dramatically and finally decreased to 0 mL/d. There was no evidence of a leak on fluoroscopic examination, and upon 4-month follow-up, we found that no symptoms had developed in the patient.

LIMITATIONS: Single-patient pilot study.

CONCLUSIONS

EHCT is very simple and efficient. EHCT can be applied as a means of closing the orifice of a postoperative fistula that is not easily managed by simple endoscopic clipping.