Closure of Refractory Gastrocutaneous Fistula With Endoscopically Guided Percutaneous Suturing With the Use of Miniature Biopsy Forceps

Authors

Rogelio Garcia
Juan D Gomez Cifuentes
Fuad Aloor
Tara Keihanian
Marvin Ryou
Wasif M Abidi

Publication Date

7-1-2023

Journal

VideoGIE

DOI

10.1016/j.vgie.2023.03.006

PMID

37456216

PMCID

PMC10339015

PubMedCentral® Posted Date

5-12-2023

PubMedCentral® Full Text Version

Post-Print

Published Open-Access

yes

Abstract

A PEG tube is an ideal option for enteral nutrition in patients with impaired swallowing or for nutrition optimization. After PEG tube removal, the tract usually closes spontaneously. However, persistent gastrocutaneous fistula (GCF) is a rare but well-known adverse event of long-term PEG tube use.¹ Despite the evolution of endoscopic techniques over the last decade, such as over-the-scope clips (OTSCs), endoscopic suturing, and biosynthetic glue plaque, the management of GCF remains challenging.2, 3, 4, 5, 6 Although endoscopic suturing results in full-thickness closure of the gastric wall, persistent leakage from the cutaneous site may still occur, requiring surgical intervention for the management of the fistula. We report a case of successful GCF closure with an endoscopically guided percutaneous suturing technique using miniature biopsy forceps. Video shows closure of a refractory gastrocutaneous fistula with endoscopically guided percutaneous suturing with the use of miniature biopsy forceps.

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