title: Endoscopic sealing of pancreatic fistula by using N-butyl-2-cyanoacrylate.
abstract: BACKGROUND
  The treatment of pancreatic fistula can be difficult. A novel endoscopic approach to sealing pancreatic fistulas by using N-butyl-2-cyanoacrylate is described.
  
  
  METHODS
  Twelve patients with pancreatic fistulas underwent endoscopic injection of N-butyl-2-cyanoacrylate into the fistulous tract, in addition to endoscopic drainage.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Interdisciplinary Endoscopy, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Seewald
authors.forename: Boris
authors.initials: B
authors.lastname: Brand
authors.forename: Stefan
authors.initials: S
authors.lastname: Groth
authors.forename: Salem
authors.initials: S
authors.lastname: Omar
authors.forename: Gerardo
authors.initials: G
authors.lastname: Mendoza
authors.forename: Uwe
authors.initials: U
authors.lastname: Seitz
authors.forename: Ichiro
authors.initials: I
authors.lastname: Yasuda
authors.forename: He
authors.initials: H
authors.lastname: Xikun
authors.forename: Vo Chieu
authors.initials: VC
authors.lastname: Nam
authors.forename: Hong
authors.initials: H
authors.lastname: Xu
authors.forename: Frank
authors.initials: F
authors.lastname: Thonke
authors.forename: Nib
authors.initials: N
authors.lastname: Soehendra
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004659:Enbucrilate / Q000008:administration & dosage* / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016145:Endoscopy, Digestive System; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010185:Pancreatic Fistula / Q000628:therapy*; D014014:Tissue Adhesives / Q000008:administration & dosage* / Q000627:therapeutic use
chemical_list: D014014:Tissue Adhesives; D004659:Enbucrilate