• Closure techniques
• Gastrocutaneous fistula
• OTSC
• Ovesco
• PEG removal
• Pediatric surgery

• Humans
• Gastrostomy/methods
• Gastrostomy/adverse effects
• Gastric Fistula/etiology
• Gastric Fistula/surgery
• Retrospective Studies
• Male
• Female
• Cutaneous Fistula/etiology
• Cutaneous Fistula/surgery
• Child
• Child, Preschool
• Infant
• Device Removal/methods
• Adolescent
• Surgical Instruments
• Enteral Nutrition/instrumentation
• Enteral Nutrition/methods
• Treatment Outcome
• Postoperative Complications/etiology
• Postoperative Complications/surgery

• Centre Hospitalier Universitaire de Lille

• Humans
• Gastrointestinal Hemorrhage/etiology
• Surgical Instruments/adverse effects
• Recurrence
• Randomized Controlled Trials as Topic
• Endoscopy, Gastrointestinal/methods
• Hemostasis, Endoscopic/instrumentation
• Hemostasis, Endoscopic/methods
• Treatment Outcome
• Upper Gastrointestinal Tract

• 7232123 Beijing Natural Science Foundation
• L232016 Beijing Natural Science Foundation
• 2023-I2M-C&T-B-036 CAMS Innovation Fund for Medical Sciences (CIFMS)
• 2022-PUMCH-A-020 National High-Level Hospital Clinical Research Funding
• 2022-PUMCH-B-023 National High-Level Hospital Clinical Research Funding
• ZK108000 National Key Clinical Specialty Construction Project
• 32170788 National Natural Science Foundation of China

• Cohort studies
• Endoscopic self-expandable metal stent
• Endoscopy vacuum therapy
• Esophageal diseases
• Esophageal perforation

• Humans
• Esophageal Perforation/etiology
• Esophageal Perforation/surgery
• Negative-Pressure Wound Therapy
• Retrospective Studies
• Treatment Outcome
• Endoscopy, Gastrointestinal/methods
• Self Expandable Metallic Stents
• Stents

• bleeding peptic ulcer
• endoscopy
• gastrointestinal bleeding

• Humans
• Peptic Ulcer
• Peptic Ulcer Hemorrhage/prevention & control
• Peptic Ulcer Hemorrhage/surgery
• Gastrointestinal Transit
• Hospitalization
• Intensive Care Units

• Health and Medical Research Fund

• EFTR
• Gastric submucosal tumor
• closure technique

• anastomotic leak
• fistula
• gastrointestinal perforation
• wound closure technique

• Perforation
• endoscopic closure
• endoscopic submucosal dissection
• endoscopic suturing
• over the scope clips

Radiofrequency ablation (RFA) and microwave ablation (MWA) represent the standard of care for patients with early hepatocellular carcinoma (HCC) who are unfit for surgery. The incidence of reported adverse events is low, ranging from 2.4% to 13.1% for RFA and from 2.6% to 7.5% for MWA. Gastrointestinal tract (GIT) injury is even more infrequent (0.11%), but usually requires surgery with an unfavourable prognosis. Due to its low incidence and the retrospective nature of the studies, the literature reporting this feared complication is heterogeneous and in many cases lacks information on tumour characteristics, comorbidities and treatment approaches.

A 77-year-old man who had undergone extended right hepatectomy for HCC was diagnosed with early disease recurrence with a small nodule compatible with HCC in the Sg4b segment of the liver with a subcapsular location. He was treated with percutaneous RFA and a few week later he was urgently admitted to the Surgery ward for abdominal pain and fever. A subcutaneous abscess was diagnosed and treated by percutaneous drainage. A fistulous tract was then documented by the passage of contrast material from the gastric antrum to the abdominal wall. The oesophagogastroduodenoscopy confirmed a circular wall defect at the lesser curvature of gastric antrum, leading directly to the purulent abdominal collection. An over-the-scope clip (OTSC) was used to successfully close the defect

This is the first reported case of RFA-related GIT injury to have been successfully treated with an OTSC, which highlights the role of this endoscopic treatment for the management of this complication.

• Gastrointestinal tract
• Radiofrequency ablation
• Hepatocellular carcinoma
• Complications
• Endoscopy
• Over-the-scope clip
• Case report

• Aged
• Carcinoma, Hepatocellular/surgery
• Catheter Ablation/adverse effects
• Gastrointestinal Tract
• Humans
• Liver Neoplasms/surgery
• Male
• Neoplasm Recurrence, Local
• Retrospective Studies

Recent advances in endoscopic tools and techniques have allowed the minimally invasive management of iatrogenic gastrointestinal (GI) perforations and bleedings. However, surgery may be required in cases with larger defects and bleeding refractory to conventional endoscopic modalities. The use of over-the-scope clips (OTSC) has been shown to improve the outcomes in these patients compared with conventional treatment modalities. In this study, we evaluated the safety and efficacy of OTSC for different indications in the GI tract.

The data of consecutive patients in whom OTSC was utilized for different indications between February 2017 and October 2019 were analyzed retrospectively. The following outcomes were recorded: technical and clinical success, and adverse events related to the procedure.

Thirty-six patients (22 male, mean age 52.673±14.97 years, range 11-72 years) underwent OTSC application. Indications for OTSC were: GI defects (perforation n=13, fistula n=5); esophageal metallic stent fixing n=9; GI bleeding n=8; and neuroendocrine tumor endotherapy n=1. The average size of the defect was 15.88±8.01 mm. The technical and clinical success rates were 88.89% and 83.33%, respectively. There were 4 (11.1%) technical failures: colonic perforations n=2; duodenal ulcer bleeding n=1; and esophageal metal stent fixation n=1. There were 2 (9.5%) adverse events, including 1 partial duodenal obstruction and 1 delayed bleeding.

The use of OTSC is safe, easy and effective for various indications in the GI tract. Prospective trials are required to see if the use of OTSC is cost effective as a primary endoscopic treatment method in these cases.

• Endoscopy
• bleeding
• full-thickness resection
• perforation

• Anastomotic leak
• Endoscopic resection
• Fistula closure
• Hemostasis
• Over-the-scope clip
• Ovesco Endoscopy
• Perforation

• Anastomotic Leak/etiology
• Anastomotic Leak/surgery
• Endoscopy, Gastrointestinal
• Gastrointestinal Hemorrhage/etiology
• Gastrointestinal Hemorrhage/surgery
• Humans
• Retrospective Studies
• Stents
• Surgical Instruments
• Treatment Outcome

Nonvariceal upper gastrointestinal hemorrhage (NVUGIH) is more prevalent than lower gastrointestinal hemorrhage and carries a high risk of mortality in the elderly, especially those with significant cardiovascular comorbidities. Traditional endoscopic methods, such as through-the-scope clips, electrocautery, and epinephrine injection, are frequently used to control these bleeds; however, they carry a 10% risk of rebleeding, and this itself carries a mortality risk of 36%. The larger over-the-scope clips (OTSC) that were initially used for the closure of fistulas and perforations are now gradually being implemented to manage NVUGIH. To our knowledge, we present the first cases to be reported in the literature where OTSC was successfully used as salvage therapy for refractory acute upper gastrointestinal bleeders who failed traditional endoscopic management and interventional radiology-guided embolization of the bleeding artery. We also provide an up-to-date literature review on the use of OTSC and its superiority to traditional endoscopic interventions in the management of complicated NVUGIH.

• Angiography
• Nonvariceal bleed
• Over-the-scope clip
• Posterior duodenal wall ulcer
• Refractory gastrointestinal bleed
• Through-the-scope clip
• Upper gastrointestinal hemorrhage

• Endoscopic closure
• Fistula
• Over the scope clip
• Perforation

• Endoscopic
• Gastrointestinal bleeding
• Meta-analysis
• Over-the-scope clip
• Systematic review

• Acute Disease
• Feasibility Studies
• Gastrointestinal Hemorrhage/etiology
• Gastrointestinal Hemorrhage/therapy
• Hemostasis, Endoscopic/adverse effects
• Hemostasis, Endoscopic/instrumentation
• Hemostasis, Endoscopic/methods
• Humans
• Publication Bias
• Recurrence
• Treatment Outcome

• No. 2017196257 Medical science and technology plan projects of Zhejiang Province
• No. 0903-00031099 Youth Foundation of Southwest Medical University
• No. 16229 Doctoral research start-up funding project of Affiliated Hospital of Southwest Medical University

The Padlock clip is a recently introduced over-the-scope clip (OTSC) that requires the use of an alternate technique and has a different design from previous OTSCs. However, data regarding its clinical use are limited. The aim of this study is to present our clinical experience using this novel Padlock clip system.

Between September 2018 and June 2019, 7 consecutive patients underwent Padlock clip application at our center by an experienced endoscopist. A Padlock clip was used for achieving hemostasis in 4 patients presenting with gastrointestinal (GI) bleeding, as well as for endoscopic full-thickness resection in the remaining 3 patients.

All 7 patients achieved technical as well as clinical success, with absence of complications or rebleeding, during a follow-up of a minimum of 3 weeks. All patients were hospitalized post procedure for a minimum of 48 hours, and an absence of adverse events was noted in our patient population throughout the procedure and post-procedure period. Antiplatelet therapy was reinstated shortly after the application of the Padlock clip, with no GI bleeding observed.

The Padlock clip is a novel OTSC, with benefits that include safe, simple, and rapid deployment. Antiplatelet therapy may be reinstated for patients, when necessary, shortly after applying the Padlock clip due to full-thickness closure of the tissue.

• Endoscopic management
• Gastrointestinal hemorrhages
• Novel over-the-scope clip
• Over-the-scope clip
• Padlock

• OTSC
• endoscopic band ligation
• endoscopic therapy
• liver cirrhosis
• variceal bleeding

• bleeding
• endoscopy
• gastric cancer
• palliative radiotherapy
• transcatheter arterial embolization

• Over the scope clip
• endoscopic full thickness resection
• gastric hemorrhage

• Clip Ovesco
• Esophageal perforation
• Fistula
• Fístula
• Intestinal perforation
• Over-The-Scope Clip System
• Perforación esofágica
• Perforación intestinal

• GI hemorrhage
• GI lesions
• Meta-analysis
• clip
• endoscopic treatment

• endoscopic closure
• gastrointestinal defects
• over-the-scope clip

This report describes a 52-year-old male patient with blunt abdominal traumatic rupture of the spleen due to injuries sustained in an automobile accident. Following splenectomy, the patient developed a gastric fistula. He underwent a long period of conservative treatment, including antibiotics and total parenteral nutrition, which was ineffective. The fistula could not be closed and titanium clip closure using a gastroscopy was then performed in order to close the fistula. After endoscopic therapy and clipping surgery, the patient’s general condition improved significantly, and he had no post-procedural abdominal complications. On post-clipping day 6, the gastric fistula was completely closed as shown by X-ray examination of the upper digestive tract. The patient was discharged from hospital and no complications were observed during the six-month follow-up period. Our report suggests that titanium clip closure using endoscopy may be the choice of treatment in patients with a gastric fistula.

• Titanium clipping
• Endoscopy
• Splenectomy
• Case report
• Gastric fistula