Management of low-output pancreatic fistulas with fibrin glue.
BACKGROUND
Despite advances in surgical, endoscopic, and percutaneous therapeutic techniques, pancreatic fistulas remain a source of significant morbidity and long-term patient discomfort. The intraoperative use of fibrin sealant has been used prophylactically to prevent formation of fistula. We recognized the potential use of fibrin glue as a therapeutic modality for successful resolution of low-output pancreatic fistulas.


METHODS
Three patients with low (<20 ml per day) output pancreatic fistulas underwent fluoroscopically directed injection of fibrin glue along their fistula tract.


RESULTS
All 3 patients underwent successful fibrin glue injection without procedural complication. All fistula output stopped, and the 3 patients remained asymptomatic at 1 year.


CONCLUSIONS
Fibrin glue inserted with image-guided catheter delivery systems may be a useful option in selected patients with low-output pancreatic fistulas.
Cothren
C Clay
CC
Department of Surgery, Denver Health Medical Center, 777 Bannock St., MC 0206, Denver, CO 80204, USA. clay.cothren@dhha.org
McIntyre
Robert C
RC
Johnson
Stephen
S
Stiegmann
Gregory V
GV
D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010185:Pancreatic Fistula / Q000000981:diagnostic imaging / Q000628:therapy*; D011183:Postoperative Complications / Q000628:therapy; D015641:Radiography, Interventional / Q000379:methods*; D014014:Tissue Adhesives / Q000627:therapeutic use*
D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives