Endoscopic treatment of biliary leakage with n-butyl-2 cyanoacrylate.
BACKGROUND
Biliary leakage is a problematic complication of hepatobiliary surgery. A novel alternative method is described that can obviate the need for reoperation for refractory biliary fistula.


METHODS
Nine patients with large biliary leaks unresponsive to endoscopic drainage underwent N-butyl-2-cyanoacrylate glue occlusion at ERCP.


RESULTS
In 7 patients, occlusion was successful with prompt control of the fistula in a single session, averting reoperation. In 1 patient there was a partial response and in another the treatment was unsuccessful. No procedure-related complication occurred over a median follow-up of 35 months (range: 1.6-160 months).


CONCLUSIONS
N-butyl-2-cyanoacrylate glue occlusion is a safe and effective endoscopic method for control of refractory bile leaks that eliminates the need for surgical reintervention.
Seewald
Stefan
S
Department of Interdisciplinary Endoscopy, University Hospital, Hamburg-Eppendorf, Germany.
Groth
Stefan
S
Sriram
Parupudi V J
PV
Xikun
He
H
Akaraviputh
Thawatchai
T
Mendoza
Gerardo
G
Brand
Boris
B
Seitz
Uwe
U
Thonke
Frank
F
Soehendra
Nib
N
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001652:Bile Ducts / Q000293:injuries*; D001658:Biliary Fistula / Q000000981:diagnostic imaging / Q000188:drug therapy*; D002758:Cholangiography; D004659:Enbucrilate / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016717:Sphincterotomy, Endoscopic; D014014:Tissue Adhesives / Q000008:administration & dosage / Q000627:therapeutic use*
D014014:Tissue Adhesives; D004659:Enbucrilate