title: Management of low-output pancreatic fistulas with fibrin glue.
abstract: 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.
authors.affiliation: Department of Surgery, Denver Health Medical Center, 777 Bannock St., MC 0206, Denver, CO 80204, USA. clay.cothren@dhha.org
authors.forename: C Clay
authors.initials: CC
authors.lastname: Cothren
authors.forename: Robert C
authors.initials: RC
authors.lastname: McIntyre
authors.forename: Stephen
authors.initials: S
authors.lastname: Johnson
authors.forename: Gregory V
authors.initials: GV
authors.lastname: Stiegmann
mesh_terms: 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*
chemical_list: D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives