Cereatti F, Grassia R, Drago A, Conti CB, Donatelli G. Endoscopic management of gastrointestinal leaks and fistulae: What option do we have? World J Gastroenterol 2020; 26(29): 4198-4217 [PMID: 32848329 DOI: 10.3748/wjg.v26.i29.4198]
Corresponding Author of This Article
Fabrizio Cereatti, MD, Doctor, Digestive Endoscopy and Gastroenterology Unit, Cremona Hospital, Viale Concordia 1, Cremona 26100, Italy. cereatti.fabrizio@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Aug 7, 2020; 26(29): 4198-4217 Published online Aug 7, 2020. doi: 10.3748/wjg.v26.i29.4198
Endoscopic management of gastrointestinal leaks and fistulae: What option do we have?
Fabrizio Cereatti, Roberto Grassia, Andrea Drago, Clara Benedetta Conti, Gianfranco Donatelli
Fabrizio Cereatti, Roberto Grassia, Andrea Drago, Clara Benedetta Conti, Digestive Endoscopy and Gastroenterology Unit, Cremona Hospital, Cremona, Cremona 26100, Italy
Gianfranco Donatelli, Department of Interventional Endoscopy, Hospital Prive Peupliers, Ramsay Santé, Paris 75013, France
Author contributions: All authors contributed to this review with conception and design, literature review, drafting and critical revision, editing, and approval of the final version.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Fabrizio Cereatti, MD, Doctor, Digestive Endoscopy and Gastroenterology Unit, Cremona Hospital, Viale Concordia 1, Cremona 26100, Italy. cereatti.fabrizio@gmail.com
Received: May 18, 2020 Peer-review started: May 18, 2020 First decision: June 4, 2020 Revised: June 10, 2020 Accepted: July 23, 2020 Article in press: July 23, 2020 Published online: August 7, 2020 Processing time: 80 Days and 13.2 Hours
Core Tip
Core tip: Early diagnosis of gastrointestinal leaks and fistulae is associated with better outcomes. Endoscopic minimally invasive management is becoming the treatment of choice for gastrointestinal wall defects. It is more effective and safer than surgery. Several endoscopic devices and techniques are available, and they include endoclip, metal or plastic stent, tissue sealants, suturing systems and vacuum therapy. The choice of one procedure over another should depend on clinical presentation, defect features and local expertise. Early leaks have a higher rate of longstanding healing compared to late leaks and fistulae. A close collaboration between surgeons, interventional radiologists and therapeutic endoscopists is recommended to assure a favorable outcome.
