Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
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:
Corresponding author: Fabrizio Cereatti, MD, Doctor, Digestive Endoscopy and Gastroenterology Unit, Cremona Hospital, Viale Concordia 1, Cremona 26100, Italy.
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
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.