Endoscopists should pay particular attention to early indicators suggesting endoscopic perforation during therapeutic endoscopy as well as diagnostic endoscopy. Endoscopic closure modalities should be selected according to the size and nature of defect. New minimally invasive endoscopic treatment options, including endoclipping (through the scope clips and over-the-scope clips), fibrin glue with or without Vicryl mesh, stent placement, and endoscopic vacuum therapy, have emerged for alternatives to conventional surgical treatment. Outcomes of endoscopic treatment with reference to successful sealing and mortality are favorable, compared with surgery.
This is a preview of subscription content, log in to check access.
Raju GS. Endoscopic closure of gastrointestinal leaks. Am J Gastroenterol. 2009;104:1315–20.CrossRefGoogle Scholar
Swan MP, Bourke MJ, Moss A, et al. The target sign: an endoscopic marker for the resection of the muscularis propria and potential perforation during colonic endoscopic mucosal resection. Gastrointest Endosc. 2011;73:79–85.CrossRefGoogle Scholar
Shim CN, Kim HI, Hyung WJ, et al. Self-expanding metal stents or nonstent endoscopic therapy: which is better for anastomotic leaks after total gastrectomy? Surg Endosc. 2014;28:833–40.CrossRefGoogle Scholar
Gomez-Esquivel R, Raju GS. Endoscopic closure of acute esophageal perforations. Curr Gastroenterol Rep. 2013;15:321.CrossRefGoogle Scholar
Kim YJ, Shin SK, Lee HJ, et al. Endoscopic management of anastomotic leakage after gastrectomy for gastric cancer: how efficacious is it? Scand J Gastroenterol. 2013;48:111–8.CrossRefGoogle Scholar
Baron TH, Wong Kee Song LM, Zielinski MD, et al. A comprehensive approach to the management of acute endoscopic perforations (with videos). Gastrointest Endosc. 2012;76:838–59.CrossRefGoogle Scholar
van Boeckel PG, Dua KS, Weusten BL, et al. Fully covered self-expandable metal stents (SEMS), partially covered SEMS and self-expandable plastic stents for the treatment of benign esophageal ruptures and anastomotic leaks. BMC Gastroenterol. 2012;12:19.CrossRefGoogle Scholar
Mennigen R, Senninger N, Laukoetter MG. Novel treatment options for perforations of the upper gastrointestinal tract: endoscopic vacuum therapy and over-the-scope clips. World J Gastroenterol. 2014;20:7767–76.CrossRefGoogle Scholar
van Boeckel PG, Sijbring A, Vleggaar FP, et al. Systematic review: temporary stent placement for benign rupture or anastomotic leak of the oesophagus. Aliment Pharmacol Ther. 2011;33:1292–301.CrossRefGoogle Scholar