Endoscopic Closure of a Duodenal Perforation Secondary to Postoperative Pancreatic Fistula Using Novel Through‐The‐Scope Closure Devices in Surgically Altered Anatomy

With supporting video, Oka and colleagues describe endoscopic closure of a blind-end duodenal perforation secondary to postoperative pancreatic fistula in surgically altered anatomy. Using balloon-assisted endoscopy, an 8-mm perforation was successfully closed with through-the-scope Dual Action Tissue™ and MANTIS™ clips, demonstrating a minimally invasive alternative when over-the-scope devices are impractical.