[Endoscopic treatment of gastrointestinal fistulas with biological fibrin glue].
OBJECTIVE
We summarize our experience of endoscopic treatment of gastrointestinal fistulas with fibrin glue.


METHODS
We retrospectively reviewed the outcome of 30 patients with gastrointestinal fistulas (9 internal and 21 external) refractory to standard conservative treatment for at least 10 days. Once the fistula was endoscopically located, 4 to 8 ml of reconstituted fibrin glue (Tissucol 2.0) at 37 degrees C was injected through a Duplocath catheter on a weekly basis.


RESULTS
The mean age was 59 years (32-87) and 63% were men. A total of 21.9% of the patients had high output fistulas. We were able to find all fistular orifices what were located close to the surgical anastomosis. Healing time was 17 days (4-90); 2.8 sessions were required per patient (1-5) but only 2.3 sessions were required in responders. Complete sealing of fistulas was achieved in 75%; (80% in low-output, 25% in high-output and 55.5% in internal fistulas). The frequency of fistula recurrence was 3.3%. No complications related to the sealing procedure were found. Overall mortality was 10%, but only 6.6% was related to persistence of the fistula.


CONCLUSIONS
Endoscopic treatment of fistulas with biological glue has a high success rate in sealing without complications, helping to speed up the healing process and reduce costs, particularly in low-output enterocutaneous fistulas.
Ramón Rábago
Luis
L
Sección de Digestivo. Hospital Severo Ochoa. Leganés. Madrid. España. lrabagot@meditex.es
Moral
Ignacio
I
Delgado
María
M
Guerra
Iván
I
Quintanilla
Elvira
E
Castro
José Luis
JL
Llorente
Rosa
R
Martínez Veiga
José Luis
JL
Gea
Francisco
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016154:Digestive System Fistula / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D016145:Endoscopy, Digestive System / Q000009:adverse effects / Q000379:methods; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome
D015718:Fibrin Tissue Adhesive