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Endoscopic sealing of pancreatic fistula by using N-butyl-2-cyanoacrylate

2004; Elsevier BV; Volume: 59; Issue: 4 Linguagem: Inglês

10.1016/s0016-5107(03)02708-1

1097-6779

Stefan Seewald, Boris Brand, Stefan Groth, Salem Omar, Gerardo Mendoza, Uwe Seitz, Ichiro Yasuda, He Xikun, Vo Chieu Nam, Hong Xu, Frank Thonke, N. Soehendra,

Pancreatitis Pathology and Treatment

The treatment of pancreatic fistula can be difficult. A novel endoscopic approach to sealing pancreatic fistulas by using N-butyl-2-cyanoacrylate is described.Twelve patients with pancreatic fistulas underwent endoscopic injection of N-butyl-2-cyanoacrylate into the fistulous tract, in addition to endoscopic drainage.Fistulas were closed successfully in 8 of 12 patients. A single treatment session was successful in 7 patients; a second session was required in one patient. In two patients, closure was temporary, and, in one patient, the treatment failed. One patient died 24 hours after treatment. He developed a pulmonary thromboembolism from a left popliteal vein thrombosis and died from complications of surgical thromboembolectomy. At autopsy, a pulmonary embolus was found, but there was no evidence of N-butyl-2-cyanoacrylate in the lungs. No procedure-related complication occurred over a median follow-up of 20.7 months (range 9-51 months).In this preliminary study, occlusion of pancreatic fistulas by using N-butyl-2-cyanoacrylate glue was safe and effective, and obviated the need for surgery in a substantial proportion of patients. Further studies of the use of N-butyl-2-cyanoacrylate for closure of pancreatic fistula are warranted.