Large post-surgical duodenal leak treatment during enteroscopy session close it in one shot

Abstract Text A 70-year-old-man affected by duodenal primary malignant stenosis was treated with Billroth II distal gastrectomy/duodenectomy and pancreatic neck enucleation, complicated by haemorragic shock, biliary leak and a duodenal perforation, all related to pancreatic fistula. Considering the difficulty of both a new surgery and a second enteroscopy session in a fragile patient, an endoscopic therapeutic one-session rescue procedure was attempted. We attempt to close the duodenal leak with a 11 mm OTS-clip, with 3 mm residual leak, “looping the clips technique” plus cyanoacrylate injection were then performed [1] [2] [3].