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Mönkemüller K, Peter S, Alkurdi B, et al. Endoscopic closure of a gastrocolic fistula using the over-the-scope-clip-system. World J Gastrointest Endosc. 2013;5(8):402-6doi: 10.4253/wjge.v5.i8.402.
Mönkemüller, K., Peter, S., Alkurdi, B., Ramesh, J., Popa, D., & Wilcox, C. M. (2013). Endoscopic closure of a gastrocolic fistula using the over-the-scope-clip-system. World journal of gastrointestinal endoscopy, 5(8), 402-6. https://doi.org/10.4253/wjge.v5.i8.402
Mönkemüller, Klaus, et al. "Endoscopic closure of a gastrocolic fistula using the over-the-scope-clip-system." World journal of gastrointestinal endoscopy vol. 5,8 (2013): 402-6. doi: https://doi.org/10.4253/wjge.v5.i8.402
Mönkemüller K, Peter S, Alkurdi B, Ramesh J, Popa D, Wilcox CM. Endoscopic closure of a gastrocolic fistula using the over-the-scope-clip-system. World J Gastrointest Endosc. 2013 Aug 16;5(8):402-6. doi: 10.4253/wjge.v5.i8.402. PMID: 23951396; PMCID: PMC3742706.
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World J Gastrointest Endosc. 2013 Aug 16;5(8):402-6. doi: 10.4253/wjge.v5.i8.402.

Endoscopic closure of a gastrocolic fistula using the over-the-scope-clip-system.

World journal of gastrointestinal endoscopy

Klaus Mönkemüller, Shajan Peter, Basem Alkurdi, Jayapal Ramesh, Daniel Popa, C Mel Wilcox

Affiliations

  1. Klaus Mönkemüller, Shajan Peter, Basem Alkurdi, Jayapal Ramesh, Daniel Popa, C Mel Wilcox, Division of Gastroenterology and Hepatology, Basil Hirschowitz Endoscopic Center of Excellence, University of Alabama at Birmingham, Birmingham, AL 35249, United States.

PMID: 23951396 PMCID: PMC3742706 DOI: 10.4253/wjge.v5.i8.402

Abstract

Gastrointestinal (GI) defects such as fistulas and leaks can be potentially closed endoscopically using hemoclips and loops. However, hemoclips may not allow for closure of large defects and they do not exert enough tensile force to keep fibrotic defects larger than 5 mm approximated. Herein we present a case of successful endoscopic closure of a gastrocolic fistula in a severely malnourished patient with complex post-surgical upper GI anatomy. We strongly believe that this device is a major breakthrough for the management of various types of discontinuity defects or fistulas. In addition, we show the usefulness of placing a direct jejunostomy using the double balloon enteroscopy (DBE) technique during the same procedure. The concept of providing direct jejunal feedings while allowing for upper gastrointestinal bowel rest to promote the healing of the minimally invasive endoscopic operation is novel. Thus, our case is unique and exemplifies the utility of minimally invasive endoscopic endoluminal surgery.

Keywords: Bear claw; Clip; Endoscopic closure; Fistula; Gastrocolic fistula; Over the scope clip; Over-the-scope-clip

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