Endoscopic sealing of pancreatic fistula by using N-butyl-2-cyanoacrylate.

Abstract

BACKGROUND:

The treatment of pancreatic fistula can be difficult. A novel endoscopic approach to sealing pancreatic fistulas by using N-butyl-2-cyanoacrylate is described.

METHODS:

Twelve patients with pancreatic fistulas underwent endoscopic injection of N-butyl-2-cyanoacrylate into the fistulous tract, in addition to endoscopic drainage.

RESULTS:

Fistulas were closed successfully in 8 of 12 patients. A single treatment session was successful in 7 patients; a second session was required in one patient. In two patients, closure was temporary, and, in one patient, the treatment failed. One patient died 24 hours after treatment. He developed a pulmonary thromboembolism from a left popliteal vein thrombosis and died from complications of surgical thromboembolectomy. At autopsy, a pulmonary embolus was found, but there was no evidence of N-butyl-2-cyanoacrylate in the lungs. No procedure-related complication occurred over a median follow-up of 20.7 months (range 9-51 months).

CONCLUSIONS:

In this preliminary study, occlusion of pancreatic fistulas by using N-butyl-2-cyanoacrylate glue was safe and effective, and obviated the need for surgery in a substantial proportion of patients. Further studies of the use of N-butyl-2-cyanoacrylate for closure of pancreatic fistula are warranted.

• Authors: Stefan Seewald, Boris Brand, Stefan Groth, Salem Omar, Gerardo Mendoza, Uwe Seitz, Ichiro Yasuda, He Xikun, Vo Chieu Nam, Hong Xu, Frank Thonke, Nib Soehendra
• Journal: Gastrointestinal endoscopy (Gastrointest Endosc) Vol. 59 Issue 4 Pg. 463-70 (Apr 2004) ISSN: 0016-5107 [Print] United States
• PMID: 15044879 (Publication Type: Journal Article)

Chemical References

• Tissue Adhesives
• Enbucrilate

Topics

• Adult
• Aged
• Aged, 80 and over
• Enbucrilate (administration & dosage, analogs & derivatives, therapeutic use)
• Endoscopy, Digestive System
• Female
• Humans
• Male
• Middle Aged
• Pancreatic Fistula (therapy)
• Tissue Adhesives (administration & dosage, therapeutic use)