title: Endoscopic treatment of biliary leakage with n-butyl-2 cyanoacrylate.
abstract: 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.
authors.affiliation: Department of Interdisciplinary Endoscopy, University Hospital, Hamburg-Eppendorf, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Seewald
authors.forename: Stefan
authors.initials: S
authors.lastname: Groth
authors.forename: Parupudi V J
authors.initials: PV
authors.lastname: Sriram
authors.forename: He
authors.initials: H
authors.lastname: Xikun
authors.forename: Thawatchai
authors.initials: T
authors.lastname: Akaraviputh
authors.forename: Gerardo
authors.initials: G
authors.lastname: Mendoza
authors.forename: Boris
authors.initials: B
authors.lastname: Brand
authors.forename: Uwe
authors.initials: U
authors.lastname: Seitz
authors.forename: Frank
authors.initials: F
authors.lastname: Thonke
authors.forename: Nib
authors.initials: N
authors.lastname: Soehendra
mesh_terms: 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*
chemical_list: D014014:Tissue Adhesives; D004659:Enbucrilate