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Case Reports
Endoscopic Management of Gastrointestinal Leaks and Perforation with Polyglycolic Acid Sheets
Sojung Han, Hyunsoo Chung, Jun Chul Park, Sung Kwan Shin, Sang Kil Lee, Yong Chan Lee
Clin Endosc 2017;50(3):293-296.   Published online March 8, 2017
DOI: https://doi.org/10.5946/ce.2016.121
AbstractAbstract PDFPubReaderePub
Gastrointestinal (GI) leakage, fistulae, and perforations can be serious and life threatening. There has been a paradigm shift in the management approach of these conditions, from surgical to conservative, including endoscopic management. Here, we report two cases of endoscopic closure of a GI fistula and perforation using polyglycolic acid (PGA) sheets with fibrin glue. The first case is of an anastomotic leak detected after subtotal gastrectomy with gastroduodenostomy. After failed application of endoclips, a PGA sheet was applied, and the fistula was successfully closed. The second case was of a 15-mm large perforated gastric ulcer, which was also successfully closed with a PGA sheet. This is the first case report that PGA sheet was used for the treatment of overt perforation. The outcome of these cases suggest that endoscopic closure using PGA sheets can be considered as a useful alternative for the management of GI leakage, fistulae, and perforations.

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Citations to this article as recorded by  
  • A Randomized Controlled Trial of Fibrin Glue to Prevent Bleeding After Gastric Endoscopic Submucosal Dissection
    Hyun Deok Lee, Eunwoo Lee, Sang Gyun Kim, Cheol Min Shin, Jun Chul Park, Kee Don Choi, Seokyung Hahn, Soo-Jeong Cho
    American Journal of Gastroenterology.2023; 118(5): 892.     CrossRef
  • Large anastomotic leak: endoscopic treatment using combined fibrin glue and polyglycolic acid (PGA) sheets
    Soo In Choi, Ji Young Park
    BMJ Case Reports.2021; 14(8): e240188.     CrossRef
  • The treatment for refractory rectovaginal fistula after low anterior resection with estriol, polyglycolic acid sheets and primary closure: A case report
    Masatsugu Hiraki, Toshiya Tanaka, Tadayuki Kanai, Takuya Shimamura, Osamu Ikeda, Makio Yasunaga, Shinichi Ogata, Kenji Kitahara
    International Journal of Surgery Case Reports.2020; 75: 483.     CrossRef
  • Endoscopic management of esophagorespiratory fistulas
    Brian Larson, Douglas G. Adler
    Techniques in Gastrointestinal Endoscopy.2019; 21(2): 65.     CrossRef
  • Endoscopic closure of an anastomo-cutaneous fistula: Filling and shielding using polyglycolic acid sheets and fibrin glue with easily deliverable technique
    Hideaki Kawabata, Yuji Okazaki, Naonori Inoue, Yukino Kawakatsu, Misuzu Hitomi, Masatoshi Miyata, Shigehiro Motoi
    Endoscopy International Open.2018; 06(08): E994.     CrossRef
  • Successful Endoscopic Closure Using Polyglycolic Acid Sheets with Fibrin Glue for Nonhealing Duodenal Ulcer with Perforation after Proton Beam Therapy of Liver Tumor
    Ko Watanabe, Takuto Hikichi, Jun Nakamura, Minami Hashimoto, Tadayuki Takagi, Rei Suzuki, Mitsuru Sugimoto, Naoki Konno, Mika Takasumi, Yuki Sato, Hiroki Irie, Takashi Kimura, Akira Kenjo, Shigeru Marubashi, Katsutoshi Obara, Hiromasa Ohira
    Case Reports in Gastroenterology.2018; 12(3): 679.     CrossRef
  • 8,592 View
  • 231 Download
  • 7 Web of Science
  • 6 Crossref
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Percutaneous Endoscopic Gastrostomy Through the Sinus Tract of a Surgical Gastrostomy
Katerina Kotzampassi, George Stavrou
Clin Endosc 2015;48(1):78-80.   Published online January 31, 2015
DOI: https://doi.org/10.5946/ce.2015.48.1.78
AbstractAbstract PDFPubReaderePub

We present the case of a woman on whom a percutaneous endoscopic gastrostomy (PEG) was performed through the sinus tract of a previous surgical gastrostomy for supraglottic obstructing malignancy. Five years after the induction of the surgical gastrostomy, she experienced a peristomal leakage, leading to severe necrotizing fasciitis, with skin irritation and inflammation. Despite extensive treatment to heal the abdominal wall close to the feeding tube, it recurred 3 months later, without any obvious cause. It was thus decided to perform a new gastrostomy in a nearby normal skin area, but, since it was totally impossible for the endoscope to be passed by mouth, due to obstruction, the sinus tract of the gastrostomy was used to facilitate endoscope insertion into the stomach for a new PEG.

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  • Percutaneous endoscopic gastrostomy through a cervical esophageal fistula. An alternative, much improved technique for patient safety
    George Stavrou, Vassilios Grosomanidis, Anastasia Sarafidou, Gavriil Tsiropoulos, Stefanos Triaridis, Katerina Kotzampassi
    American Journal of Otolaryngology.2020; 41(3): 102408.     CrossRef
  • 6,345 View
  • 57 Download
  • 1 Web of Science
  • 1 Crossref
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A Case of Successful Endoscopic Management of Afferent Loop Leakages by Using Hemoclips and a Detachable Snare
Se Woo Park, M.D., Hang Lak Lee, M.D., Seong Eun Ahn, M.D., So Yeun Park, M.D., Oh Young Lee, M.D., Byung Chul Youn, M.D., Ho Soon Choi, M.D. and Jun Soo Hahm, M.D.
Korean J Gastrointest Endosc 2008;37(1):30-34.   Published online July 30, 2008
AbstractAbstract PDF
There are many complications following gastrectomy and one of the most frequent complications is anastomosis site leakage. Postoperative leakage is a serious complication in patients after they undergo gastric surgery. It can lead to the progressive deterioration in the patient's condition and quality of life and the mortality rate is nearly 60%. We encountered a case of a 75 year-old man who had the leakage of the jejunal end of the Roux limb after total gastrectomy. We performed treatment of the leakage endoscopic clipping and detachable snaring. Hemoclips were fixed at the margin of both sides of the lesion. A detachable snare was used to bind both hemoclips, so the interval was made narrow. After snare binding, five hemoclips were used for final closure of the small interval. After treatment, the leakage of the afferent loop end was completely stopped. He resumed an oral intake and was discharged without complications. (Korean J Gastrointest Endosc 2008;37:30-34)
  • 1,940 View
  • 12 Download
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