ArticleVideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy2025
Combination of through-the-scope suturing and over-the-scope clips for closure of persistent gastrocutaneous fistula after gastrostomy tube removal ("X-lock technique").
Article in VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and Aims: Persistent gastrocutaneous fistula (GCF) can occur after removal of gastrostomy tubes. Although surgical closure has historically been considered the most definitive treatment option, novel endoscopic devices have allowed for less-invasive closure techniques. Methods: We present 2 cases in which closure of persistent GCF was performed using a combination of through-the-scope suturing and an over-the-scope clip (OTSC). In the first case, the suturing system and OTSC are used simultaneously, whereas in the second case, they are used sequentially. Results: There were no immediate postprocedural adverse events after both procedures. Both patients resumed oral intake the day after the procedure was performed. The first patient has had no leakage from previous GCF for 2 months, and the second patient has not had recurrent leakage for over 12 months since closure. Conclusions: Combination of through-the-scope suturing and OTSC placement is a viable treatment option for chronic GCF after gastrostomy tube removal.
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