Gastrointest Interv.  2016 Mar;5(1):6-14. 10.18528/gii150023.

Endoscopic management of postsurgical leaks

Affiliations
  • 1Gastrointestinal Endoscopy Unit, Kasr Alainy University Hospital, Cairo University, Cairo, Egypt. h.shehab@kasralainy.edu.eg

Abstract

Postsurgical leaks are a major complication with significant mobidity and mortality. Conventional conservative and surgical approaches are highly morbid with limited success. Over the last decade several endoscopic techniques have proved effective with a favorable safety profile. Nevertheless, most data still come from retrospective series, and many studies included heterogenous patient groups pooling complex surgical leaks with minor endoscopic perforations. This review focuses on the endoscopic management of the more difficult postsurgical leaks. Stents and over-the-scope clips are currently the key endoscopic techniques for leak closure, but emerging techniques such as vacuum sponge therapy and endoscopic internal drainage have proved to be at least as effective. The current trend is to use these different techniques interchangeably or simultaneously rather than assuming a single standardized approach.

Keyword

Anastomotic leak; Esophageal fistula; Gastric fistula; Over-the-scope clips; Self expandable metallic stents

MeSH Terms

Anastomotic Leak
Drainage
Esophageal Fistula
Gastric Fistula
Humans
Mortality
Porifera
Retrospective Studies
Self Expandable Metallic Stents
Stents
Vacuum
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