Published online Aug 7, 2020. doi: 10.3748/wjg.v26.i29.4198
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: 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.