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Endoscopic closure of an anasto-cutaneous fistula
Joint Event on 12th Global Gastroenterologists Meeting & 3rd International Conference on Metabolic and Bariatric Surgery
Hideaki Kawabata, Yuji Okazaki, Naonori Inoue, Yukino Kawakatsu, Misuzu Hitomi, Masatoshi Miyata and Shigehiro Motoi
Kyoto Okamoto Memorial Hospital, Japan
ScientificTracks Abstracts: J Gastrointest Dig Syst
Abstract
Recently, endoscopic treatments of gastrointestinal leaks and fistulas, including endoclipping, stent placement, application of tissue sealants and suturing devices, have been developed, and the effectiveness of such procedures has been reported. We performed endoscopic closure of a refractory anasto-cutaneous fistula. A total of 10 small PGA sheets (Polyglycolic acid) were delivered into the fistula, the mucosa around the fistula was ablated with argon plasma coagulation, and the orifice of the fistula along with the surrounding mucosa was shielded with a piece of PGA sheet fixed with hemoclips and fibrin glue. After this procedure, the leakage from the cutaneous fistula disappeared, and the fistula was not detectable on contrast radiograms. In conclusion, MCA and endoscopic closure of anasto-cutaneous fistula with filling and shielding using PGA sheets and fibrin glue are safe, effective, lowinvasive treatment. Recent Publications 1. Rogalski P, Daniluk J, Baniukiewicz A, Wroblewski E, Dabrowski A (2015) Endoscopic management of gastrointestinal perforations, leaks and fistulas. World J Gastroenterol. 21(37):10542-52. 2. Han S, Chung H, Park J C, Shin S K, Lee S K, Lee Y C (2017) Endoscopic management of gastrointestinal leaks and perforation with polyglycolic acid sheets. Clin Endosc. 50(3):293-296. 3. Willingham F F, Buscaglia J M (2015) Endoscopic management of gastrointestinal leaks and fistulae. Clin Gastroenterol and Hepatol. 13(10):1714-1721. 4. Nagami Y, Shiba M, Tominaga K, Yamazoe S, Amano R, Fujiwara Y, Arakawa T (2015) Endoscopic closure of gastrocutaneous leakage with polyglycolic acid sheets. Endoscopy. 47 Suppl 1 UCTN:E455-E456. 5. Takano Y, Yamamura E, Kuroki Y, Maruoka N, Nagahama M, Takahashi H (2015) Novel endoscopic treatment for colocutaneous fistula after severe acute pancreatitis: filling with a polyglycolic acid sheet. Endoscopy. 47 Suppl 1 UCTN:E424-E425.Biography
Hideaki Kawabata is a core Clinical Gastroenterologist and is currently the Director of the Department of Kyoto Okamoto Memorial Hospital, Head of the Gastroenterological Center and Chief of the Palliative Care Team in the hospital. He is also a Specialist and Councilor in the Japanese Society of Gastroenterology and the Japan Gastroenterological Endoscopy Society and a Specialist in the Japanese Society of Internal Medicine and the Japanese Society of Gastrointestinal Cancer Screening.
Email:hkawabata@okamoto-hp.or.jp
