ESOBRONCHIAL FISTULA POST SLEEVE GASTRECTOMY SUCCESSFULLY TREATED BY ENDOSCOPIC SUBMUCOSAL DISSECTION AND OVER THE SCOPE CLIP

A 28 years old patient who underwent a SG complicated 2 days later by a gastrobronchial fistula, with sub-phrenic and pulmonary abscess. Drainage and closure by endoscopic OTSC failed and an esophago-jejunal anastomosis was performed. One month after, the CT scan found a re-permeabilization of the fistula between the oesophago-jejunal anastomosis and the pulmonary abscess. The patient was referred to our unit for an endoscopic submucosal dissection (ESD) around and into the fistula tract followed by closure with OTSC. The removal of the cicatricial mucosa by ESD favored new healing. Three months later the fistula was cured.