Hideaki Kawabata
Kyoto Okamoto Memorial Hospital, Japan
Title: Endoscopic closure of an anasto-cutaneous fistula
Biography
Biography: Hideaki Kawabata
Abstract
Recently, endoscopic treatments of gastrointestinal leaks and fistulas, including endoclipping, stent placement, application of tissue sealants and suturing devices, have been developed, and the effectiveness of such procedures has been reported. We performed endoscopic closure of a refractory anasto-cutaneous fistula. A total of 10 small PGA sheets (Polyglycolic acid) were delivered into the fistula, the mucosa around the fistula was ablated with argon plasma coagulation, and the orifice of the fistula along with the surrounding mucosa was shielded with a piece of PGA sheet fixed with hemoclips and fibrin glue. After this procedure, the leakage from the cutaneous fistula disappeared, and the fistula was not detectable on contrast radiograms. In conclusion, MCA and endoscopic closure of anasto-cutaneous fistula with filling and shielding using PGA sheets and fibrin glue are safe, effective, low-invasive treatment.