[Novel treatment strategy using Trafermin® consisting of bFGF for intractable pancreatic fistula following gastrectomy for gastric cancer-a case report with literature reviews].
Despite recent perioperative technological advances in gastric cancer, intractable pancreatic fistula is still a major critical complication following gastrectomy and should be specifically targeted in the effort to improve postoperative outcomes. We preliminary report here a successfully treated case with intractable pancreatic fistula using Trafermin® consisting of basic fibroblast growth factor (bFGF). A 67-year-old man underwent laparoscopic proximal gastrectomy with radical lymphadenectomy for early proximal gastric cancer (pT1bN0M0). After surgery, pancreatic fistula was occurred. Pancreatic fistula persisted for three months despite of surgical and several conservative treatments. After obtaining informed consent, we started to inject 50 μg/day of Trafermin® through a drainage tube into the dehiscence of pancreas. Consequently, pancreatic fistula was successfully closed within three weeks. Our novel treatment technique is simple, rapid and not costly. If informed consent was obtained from patients with low risk of recurrences, this technique should be recommended as one of the treatment choices for intractable pancreatic fistula following curative gastrectomy for gastric cancer.
Division of Digestive Surgery, Dept. of Surgery, Kyoto Prefectural University of Medicine.
Masataka
M
Kasuga
Shuhei
S
Komatsu
Hisashi
H
Ikoma
Daisuke
D
Ichikawa
Kazuma
K
Okamoto
Atsushi
A
Shiozaki
Hitoshi
H
Fujiwara
Yasutoshi
Y
Murayama
Yoshiaki
Y
Kuriu
Masayoshi
M
Nakanishi
Toshiya
T
Ochiai
Yukihito
Y
Kokuba
Eigo
E
Otsuji
D000368:Aged; D016222:Fibroblast Growth Factor 2 / Q000627:therapeutic use*; D005346:Fibroblast Growth Factors / Q000627:therapeutic use*; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D010185:Pancreatic Fistula / Q000188:drug therapy* / Q000209:etiology; D010446:Peptide Fragments / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000188:drug therapy*; D013274:Stomach Neoplasms / Q000601:surgery*; D014057:Tomography, X-Ray Computed
D010446:Peptide Fragments; D016222:Fibroblast Growth Factor 2; C114444:trafermin; D005346:Fibroblast Growth Factors