Combined endoscopic cautery and clip closure of chronic gastrocutaneous fistulas

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Jonathan E Teitelbaum¹, Steven A Gorcey, Victor L Fox

¹Department of Pediatric Gastroenterology and Nutrition, Monmouth Medical Center, Long Branch, New Jersey, USA.

Gastrointestinal Endoscopy

|August 23, 2005

Abstract

Background:

Chronic gastrocutaneous fistula with intermittent drainage is a common outcome after removing long-standing gastrostomy tubes. The standard treatment is surgery with laparotomy and excision of the fistula tract. This study describes the results of an endoscopic closure technique by using a combination of electrocautery and metal clips.

Methods:

Three patients with gastrocutaneous fistulas (duration 3 months to 3 years) after gastrostomy tube removal were treated endoscopically by electrocautery of the tract and application of metal clips.

Observations:

Treatment resulted in complete fistula closure in two patients and partial closure in a third patient.

Conclusions:

Combined endoscopic therapy with electrocautery and clipping may be an alternative to surgical closure of chronic gastrocutaneous fistulas.

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