The treatment of pancreatic fistula can be difficult.
In this study, physicians from Germany describe a novel endoscopic approach using N-butyl-2-cyanoacrylate.
Overall, 12 patients with pancreatic fistulas underwent endoscopic injection of N-butyl-2-cyanoacrylate into the fistulous tract. This procedure was performed in addition to endoscopic drainage.
The physicians found that the fistulas were closed successfully in 8 of 12 patients.
|A single treatment session was successful in 7 patients.|
A single treatment session was successful in 7 patients.
The team found that the closure was temporary in 2 patients, while in 1 the treatment failed.
In addition, 1 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.
The team found that there were no procedure-related complication during a follow-up of 20.7 months.
Dr Stefan Seewald and colleagues concluded, "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".