Endoscopic sealing of pancreatic fistula by using N-butyl-2-cyanoacrylate.
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.
Seewald
Stefan
S
Department of Interdisciplinary Endoscopy, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
Brand
Boris
B
Groth
Stefan
S
Omar
Salem
S
Mendoza
Gerardo
G
Seitz
Uwe
U
Yasuda
Ichiro
I
Xikun
He
H
Nam
Vo Chieu
VC
Xu
Hong
H
Thonke
Frank
F
Soehendra
Nib
N
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
D014014:Tissue Adhesives; D004659:Enbucrilate