Endoscopic sealing of pancreatic fistulas: four case reports and review of the literature.
We report four patients with pancreatic fistulas that failed to respond to conservative treatment. The fistulas were closed by endoscopic injection of N-butyl-2-cyanoacrylate (Histoacryl) diluted with an oily contrast agent (Lipiodol). A literature review revealed 32 similar cases in which endoscopic treatment with fibrin sealants (n = 11) or cyanoacrylate (n = 21) was used to close the fistulas. Based on our own experience and the literature review, we conclude that endoscopic sealing of pancreatic fistulas can be performed safely and effectively by experienced endoscopists in a tertiary centre. The procedure seems useful in the management of complicated pancreatic fistulas which do not respond to conservative treatment and may obviate the need for surgery.
Labori
Knut Jørgen
KJ
Department of Gastroenterological Surgery, Oslo University Hospital, Oslo, Norway. knab@uus.no
Trondsen
Erik
E
Buanes
Trond
T
Hauge
Truls
T
D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods*; D003287:Contrast Media / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004659:Enbucrilate / Q000008:administration & dosage / Q000627:therapeutic use*; D016145:Endoscopy, Digestive System / Q000379:methods; D006784:Hospitals, Teaching; D006801:Humans; D007459:Iodized Oil / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010185:Pancreatic Fistula / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome
D003287:Contrast Media; D007459:Iodized Oil; D004659:Enbucrilate