Division of Gastrointestinal and Liver Diseases, University of Southern California Keck School of Medicine, Los Angeles, California, USA.
Department of Radiology, University of Southern California Keck School of Medicine, Los Angeles, California, USA.
Gastrointest Endosc. 2018 Apr;87(4):1122-1125. doi: 10.1016/j.gie.2017.08.015. Epub 2017 Aug 24.
Pancreatic fistula is a challenging yet common adverse event of partial pancreatectomy. Our objective is to determine the feasibility of endoscopic closure of a pancreatic fistula using a combination of a metallic coil and N-butyl-2-cyanoacrylate (NBCA) glue.
A patient with a postoperative pancreatic stump leak recalcitrant to conservative management and pancreatic duct stent placement underwent endoscopic/fluoroscopic placement of a metallic coil in the pancreatic duct followed by injection of .5 mL NBCA and lipiodol mixture directed at the coil. The patient's clinical condition, Jackson-Pratt (JP) drain output, and pancreatic enzyme content were monitored daily after the procedure.
The patient's clinical condition improved. JP drain output and amylase/lipase levels progressively decreased to resolution within 7 days of the procedure. No adverse events occurred as a result of the procedure.
Endoscopic closure of pancreatic fistula with a metallic coil and NBCA glue is feasible and may be a useful modality for treatment of refractory postpancreatectomy-related fistula.
胰瘘是胰腺部分切除术常见且具挑战性的不良事件。我们的目的是确定使用金属线圈和 N-丁基-2-氰基丙烯酸酯（NBCA）胶联合内镜闭合胰瘘的可行性。
一名经保守治疗和胰管支架置入后仍有胰瘘的术后胰瘘患者，接受了内镜/透视下胰管内金属线圈的放置，随后向线圈内注射 0.5 毫升 NBCA 和碘化油混合物。术后每天监测患者的临床状况、Jackson-Pratt（JP）引流量和胰酶含量。
患者的临床状况改善。JP 引流量和淀粉酶/脂肪酶水平在术后 7 天内逐渐下降至正常。该操作无不良事件发生。
内镜下使用金属线圈和 NBCA 胶闭合胰瘘是可行的，可能是治疗难治性胰切除术后相关瘘的有效方法。
