Endoscopic management of surgical complications

Best Pract Res Clin Gastroenterol. 2024 Mar:69:101898. doi: 10.1016/j.bpg.2024.101898. Epub 2024 Mar 6.


While the endoscopic management of surgical complications like leaks, fistulas, and perforations is rapidly evolving, its core principles revolve around closure, drainage, and containment. Effectively managing these conditions relies on several factors, such as the underlying cause, chronicity of the lesion, tissue viability, co-morbidities, availability of devices, and expertise required to perform the endoscopy. In contrast to acute perforation, fistulas and leaks often demand a multimodal approach requiring more than one session to achieve the required results. Although the ultimate goal is complete resolution, these endoscopic interventions can provide clinical stability, enabling enteral feeding to lead to early hospital discharge or elective surgery. In this discussion, we emphasize the current state of knowledge and the prospective role of endoscopic interventions in managing surgical complications.

Keywords: Clips; Endoscopic suturing; Fistulas; Leaks; Perforation; Stent; Surgical complications; Tissue adhesives.

Publication types

  • Review

MeSH terms

  • Anastomotic Leak / etiology
  • Anastomotic Leak / surgery
  • Anastomotic Leak / therapy
  • Drainage
  • Endoscopy, Gastrointestinal / methods
  • Humans
  • Postoperative Complications* / etiology
  • Postoperative Complications* / surgery
  • Postoperative Complications* / therapy
  • Treatment Outcome