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Updated: Feb 24, 2026

Endoscopic Vacuum Therapy for the Treatment of Anastomotic Leakage after Total Gastrectomy with Esophagojejunostomy
Published on: August 22, 2025
Endoscopic Management of Gastrointestinal Fistulae
Nitin Kumar1, Michael C Larsen1, Christopher C Thompson1
1Dr Kumar is an advanced endoscopy fellow in the Division of Gastroenterology and Dr Thompson is the director of therapeutic endoscopy at Brigham and Women's Hospital in Boston, Massachusetts. Dr Larsen is an associate physician in the Digestive Disease Institute at Virginia Mason Medical Center in Seattle, Washington.
Abstract:
A gastrointestinal fistula is a common occurrence, especially after surgery. Patients who develop a fistula may have an infection, surgically altered anatomy, nutritional deficiency, or organ failure, making surgical revision more difficult. With advancements in flexible endoscopic devices and technology, new endoscopic options are available for the management of gastrointestinal fistulae. Endoscopically deployable stents, endoscopic suturing devices, through-the-scope and over-the-scope clips, sealants, and fistula plugs can be used to treat fistulae. These therapies are even more effective in combination. Despite the inherent challenges in patients with fistulae, endoscopic therapies for treatment of fistulae have demonstrated safety and efficacy, allowing many patients to avoid surgical fistula repair. In this paper, we review the emerging role of endoscopy in the management of gastrointestinal fistulae.
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