Successful closure of a refractory gastrobronchial fistula using endoscopic mucosal ablation followed by single loop-and-clips technique.

A 78-year-old man developed a late fistula between the gastroplasty pouch and right bronchus following Ivor Lewis esophagectomy for esophageal neoplasia ([Fig. 1]). He was unable to ingest food orally, necessitating the placement of a permanent percutaneous jejunostomy. He had a persistent cough, and the fistula was refractory to various endoscopic interventions, including placement of clips, tissue adhesives, and stents.