title: [A case of pancreatic and duodenal fistula after total gastrectomy successfully treated with coagulation factor XIII].
abstract: Pancreatic fistula( PF) is a challenging postoperative complication. We report a case of PF following gastrectomy successfully treated using intravenous coagulation factor XIII( FXIII).A 78-year-old man with early gastric cancer underwent total gastrectomy with Roux-en-Y reconstruction. PF developed postoperatively, following which, leakage from the duodenal stump was observed. Percutaneous drainage and re-operative surgery were performed. A somatostatin analogue, antibiotic drugs, and gabexate mesilate were administrated along with nutritional support. The pancreatic and duodenal fistula had been producing duodenal juice for over 30 days since the re-operative surgery. As suspected, reduced FXIII activity was confirmed in the patient. After administering FXIII for 5 days, the amount of duodenal juice from the fistula markedly reduced, and the fistula closed immediately afterwards. The results of our study suggest that administration of FXIII could be a reasonable and effective treatment for patients with pancreatic or/and enterocutaneous fistula who are resistant to standard treatments.
authors.affiliation: Dept. of Surgery, Sosa Municipal Hospital.
authors.forename: Hitoe
authors.initials: H
authors.lastname: Nishino
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kojima
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Oshima
authors.forename: Koji
authors.initials: K
authors.lastname: Nakagawa
authors.forename: Masao
authors.initials: M
authors.lastname: Fumura
authors.forename: Norio
authors.initials: N
authors.lastname: Kikuchi
mesh_terms: D000368:Aged; D004322:Drainage; D004378:Duodenal Diseases / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery; D005176:Factor XIII / Q000627:therapeutic use*; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D007412:Intestinal Fistula / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D010185:Pancreatic Fistula / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery; D011183:Postoperative Complications / Q000188:drug therapy* / Q000601:surgery; D013274:Stomach Neoplasms / Q000601:surgery
chemical_list: D005176:Factor XIII