A Case Report of Usefulness of Fibrin Glue Injection into the Fistula for the Treatment of Postoperative Persistent Pancreatic Fistula

Yasuharu Tokuyama, Tomohiko Furuta, Takashi Suhara, Atushi Matuo, Yoshiki Hosono and Shigetoyo Saji^*

Department of Surgery, National Insurance Kanayama Town Hospital
Department of Tumor and General Surgery, Gifu University School of Medicine^*

A 81-year-old man underwent total gastrectomy for type 4 gastric cancer from the gastric body to the antrum. A postoperative pancreatic fistula was confirmed by fistulography to be connected to the esophago-jejunostomy stump on post operative day (POD) 28 and also to the common bile duct at the next day's examination. We implemented conservative therapy using somatostatin analog and blood coagulating XIII factor, but found no effect for closing the fistula. On POD 58, fistulography showed the fistula connected to the duodenal stump, and fibrin glue injection into the fistula, closing it. He was discharged on POD 82. In our experience, fibrin glue injection has moved very useful in closing persistent postoperative pancreatic fistulas.

Key words
ost-operative pancreatic fistula, somatostatin, fibrin glue injection

Reprint requests
Yasuharu Tokuyama Division of Gastroenterological Surgery, Aichi Cancer Center Hospital 1-1 Kanokoden, Chikusa-ku, Nagoya City, 464-8681 JAPAN

Accepted
May 27, 2003

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