title: [Efficacy of over-the-scope clip for gastrointestinal fistula].
abstract: OBJECTIVE
  To explore the efficacy of over-the-scope clip (OTSC) in the treatment of gastrointestinal fistula.
  
  
  METHODS
  Clinical data of 12 gastrointestinal fistula patients, including 3 internal fistula and 9 external fistula treated with OTSC in our institute from March 2015 to May 2016 were retrospectively analyzed. OTSC was performed when pus was drained thoroughly and intra-abdominal infection around gastrointestinal fistula was controlled, and each patient received one clip to close fistula.
  
  
  RESULTS
  There were 6 female and 6 male patients with mean age of (50.1±12.6) years. The successful rate of endoscopic closure was 100% without complications including bleeding and intestinal obstruction during and after OTSC treatment. According to comprehensive evaluation, including drainage without digestive juices, no recurrence of intra-abdominal infection, no overflow of contrast medium during digestive tract radiography, and CT examination without intra-abdominal abscess, clinical gastrointestinal fistula closure was 91.7%(11/12). There was no recurrence of gastrointestinal fistula during 3 months of follow-up in 11 patients. In the remaining 1 case, the gastric fistula after laparoscopic sleeve gastrectomy recurred one week after OTSC treatment because of intra-abdominal infection surrounding fistula, and was cured by surgery finally.
  
  
  CONCLUSIONS
  The endoscopic closure treatment of OTSC for gastrointestinal fistula is successful and effective, and control of intra-abdominal infection around fistula with adequate drainage is the key point.
authors.forename: Gefei
authors.initials: G
authors.lastname: Wang
authors.forename: Zhiming
authors.initials: Z
authors.lastname: Wang
authors.forename: Xiuwen
authors.initials: X
authors.lastname: Wu
authors.forename: Yanqing
authors.initials: Y
authors.lastname: Diao
authors.forename: Yunzhao
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Research Institute of General Surgery, Nanjing General Hospital of Nanjing Military Command, Nanjing 210002, China. jiananr@gmail.com.
authors.forename: Jianan
authors.initials: J
authors.lastname: Ren
authors.forename: Jieshou
authors.initials: J
authors.lastname: Li
mesh_terms: D000328:Adult; D016154:Digestive System Fistula / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D004322:Drainage; D016099:Endoscopy, Gastrointestinal / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006801:Humans; D059413:Intraabdominal Infections / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D013492:Suppuration / Q000628:therapy; D053831:Surgical Fixation Devices