<p>Post-esophagectomy respiratory–digestive fistula (PERDF) is a life-threatening complication that can develop after esophageal cancer resection. This complication consists of an abnormal connection formed between the digestive tract and the respiratory tract. Digestive juices can migrate into the respiratory tract through the fistula, leading to severe lung infections in PERDF patients which may cause sepsis, shock, or death. Although conservative treatments form the basis of management, they are often insufficient when used alone. Alternative therapies, including stent implantation, surgery, and endoscopic treatment, are crucial for effective management. Stent implantation is the most extensively studied and widely used method at present. Endoscopic treatment can be seen as an alternative once stenting fails. Surgery is usually limited by the patients’ general condition. In some cases, it can be performed on patients with complex anatomical structures, failed stent implantation, or ineffective endoscopic treatment. In this article, we summarize current therapeutic strategies for PERDF and evaluate the potential of absorbable hydrogels as a future treatment option.</p>