Combined endoscopic cautery and clip closure of chronic gastrocutaneous fistulas

Gastrointest Endosc. 2005 Sep;62(3):432-5. doi: 10.1016/j.gie.2005.04.047.


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.

MeSH terms

  • Adolescent
  • Cautery / methods*
  • Child, Preschool
  • Chronic Disease
  • Combined Modality Therapy
  • Cutaneous Fistula / etiology
  • Cutaneous Fistula / surgery*
  • Device Removal / adverse effects
  • Endoscopy / methods
  • Female
  • Follow-Up Studies
  • Gastric Fistula / etiology
  • Gastric Fistula / surgery*
  • Gastroscopy / methods*
  • Gastrostomy / adverse effects
  • Humans
  • Male
  • Risk Assessment
  • Sampling Studies
  • Treatment Outcome
  • Wound Healing / physiology