BACKGROUND: Endoscopic clipping for closing a fistula created by surgery is often difficult because of the combination of a wide orifice and fibrosis. Creating holes for prongs of a clip may constitute a new endoscopic clipping technique for closing the wide orifice of a fistula. OBJECTIVE: To assess the feasibility of performing the endoscopic hole and clipping technique (EHCT). DESIGN: Experimental pilot study. SETTING: Tertiary-care referral center. PATIENT: This study involved 1 patient who underwent EHCT. INTERVENTIONS: EHCT was performed. MAIN OUTCOME MEASUREMENTS: Technical success and procedural complications of EHCT. RESULTS: Immediately after the procedure, drainage decreased dramatically and finally decreased to 0 mL/d. There was no evidence of a leak on fluoroscopic examination, and upon 4-month follow-up, we found that no symptoms had developed in the patient. LIMITATIONS: Single-patient pilot study. CONCLUSIONS: EHCT is very simple and efficient. EHCT can be applied as a means of closing the orifice of a postoperative fistula that is not easily managed by simple endoscopic clipping.
BACKGROUND: Endoscopic clipping for closing a fistula created by surgery is often difficult because of the combination of a wide orifice and fibrosis. Creating holes for prongs of a clip may constitute a new endoscopic clipping technique for closing the wide orifice of a fistula. OBJECTIVE: To assess the feasibility of performing the endoscopic hole and clipping technique (EHCT). DESIGN: Experimental pilot study. SETTING: Tertiary-care referral center. PATIENT: This study involved 1 patient who underwent EHCT. INTERVENTIONS: EHCT was performed. MAIN OUTCOME MEASUREMENTS: Technical success and procedural complications of EHCT. RESULTS: Immediately after the procedure, drainage decreased dramatically and finally decreased to 0 mL/d. There was no evidence of a leak on fluoroscopic examination, and upon 4-month follow-up, we found that no symptoms had developed in the patient. LIMITATIONS: Single-patient pilot study. CONCLUSIONS: EHCT is very simple and efficient. EHCT can be applied as a means of closing the orifice of a postoperative fistula that is not easily managed by simple endoscopic clipping.