Anastomotic leaks and fistulas are significant complications of gastric surgery that potentially lead to increased postoperative morbidity and mortality. Surgical intervention is reserved for cases with severe symptoms or hemodynamic instability; however, surgery carries a higher risk of complications. With advancements in endoscopic treatment options, endoscopic approaches have emerged as the primary choice for managing these complications. Endoscopic clipping is a traditional method comprising 2 main categories: through-the-scope clips and over-the-scope clips. Through-the-scope clips are user friendly and adaptable to various clinical scenarios, whereas over-the-scope clips can close larger defects. Another promising approach is endoscopic stent insertion, which has shown a high success rate for leak closure, although vigilant monitoring is required to monitor stent migration. Infection control is essential in post-surgical leakage cases, and endoscopic internal drainage provides a relatively safe and noninvasive means to manage fluids, contributing to infection control and wound healing promotion. Endoscopic suturing offers full-thickness wound closure, but requires additional training and endoscopic versatility. As a promising tool, endoscopic vacuum therapy potentially surpasses stent therapy by draining inflammatory materials and closing defects. Furthermore, the use of tissue sealants, such as fibrin glue and cyanoacrylate, has been reported to be effective in selected situations. The choice of endoscopic device should be tailored to individual cases and specific patient conditions, with careful consideration of the nature of the defect. Further extensive studies involving larger patient populations are required to provide more robust evidence on the efficacy of endoscopic approach in managing post-gastric anastomotic leaks.

中文翻译：

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胃切除术后吻合口漏的内镜干预。

吻合口瘘和瘘管是胃手术的重要并发症，可能导致术后发病率和死亡率增加。手术干预仅适用于症状严重或血流动力学不稳定的病例；然而，手术并发症的风险较高。随着内窥镜治疗方案的进步，内窥镜方法已成为治疗这些并发症的主要选择。内窥镜夹闭是一种传统方法，包括 2 个主要类别：穿过镜夹和超镜夹。透过镜夹子用户友好且适用于各种临床场景，而透过镜夹子可以闭合更大的缺陷。另一种有前途的方法是内窥镜支架插入，尽管需要警惕地监测支架迁移，但该方法已显示出封堵泄漏的高成功率。感染控制对于术后渗漏病例至关重要，内镜内引流提供了一种相对安全、无创的液体管理手段，有助于控制感染和促进伤口愈合。内窥镜缝合可实现全层伤口闭合，但需要额外的培训和内窥镜多功能性。作为一种有前途的工具，内窥镜真空治疗通过排出炎症物质和闭合缺损而可能超越支架治疗。此外，据报道，使用组织密封剂（例如纤维蛋白胶和氰基丙烯酸酯）在某些情况下是有效的。内窥镜设备的选择应根据具体病例和具体患者情况进行调整，并仔细考虑缺陷的性质。需要涉及更多患者群体的进一步广泛研究，以提供更强有力的证据，证明内窥镜方法在处理胃吻合术后漏方面的功效。