Background and Aims
Fistulas in patients with inflammatory bowel disease (IBD) pose a key challenge in
the management of these patients. We aimed to describe a novel endoscopic method to
treat patients with IBD who have fistulas.
Methods
A cohort of 29 consecutive patients with fistulas and IBD were identified in the registry
of our interventional IBD unit. An endoscopic fistulotomy with needle-knife was performed.
The primary outcome was healing of the fistula without the need for surgical intervention.
Results
A total of 29 patients underwent endoscopic fistulotomy; and the mean (± standard
deviation) age of patients undergoing the procedure was 44.2 ± 14.6 years. Thirteen
patients were male (44.8%), and 16 were female (55.2%). Twenty-six patients (89.6%)
achieved complete resolution of the fistula as confirmed by endoscopy with a guidewire
and/or cross-sectional abdominal imaging, with 10 patients (34.4%) requiring a single
endoscopic treatment session. Three patients (10.3%) had a persistent fistula and
required surgical intervention. One patient had postoperative bleeding requiring blood
transfusion and hospitalization.
Conclusion
Endoscopic fistulotomy with a needle-knife appears to be safe and effective in treating
IBD-related fistulas.
Graphical abstract
Graphical Abstract
Abbreviations:
CD (Crohn’s disease), IBD (inflammatory bowel disease), i-IBD (interventional IBD center), IPAA (ileal pouch anal anastomosis), OTSC (over-the scope clip), SD (standard deviation)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: February 28, 2018
Accepted:
February 20,
2018
Received:
May 29,
2017
Footnotes
DISCLOSURE: B. Shen is supported by the Ed and Joey Story Endowed Chair. All other authors disclosed no financial relationships relevant to this publication.
If you would like to chat with an author of this article, you may contact Dr Shen at [email protected] .
Identification
Copyright
© 2018 by the American Society for Gastrointestinal Endoscopy
