Jang JW, Park DH, Moon SH, Lee SS, Seo DW, Lee SK, Kim MH. Endoscopic fibrin glue injection for closure of pancreatocutaneous fistula following transgastric endoscopic necrosectomy. World J Gastroenterol 2008; 14(39): 6093-6095 [PMID: 18932292 DOI: 10.3748/wjg.14.6093]
Corresponding Author of This Article
Do Hyun Park, MD, PhD, Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, 388-1 pungnap-2dong, Songpagu, Seoul 138-736, South Korea. dhpark@amc.seoul.kr
Article-Type of This Article
Case Report
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World J Gastroenterol. Oct 21, 2008; 14(39): 6093-6095 Published online Oct 21, 2008. doi: 10.3748/wjg.14.6093
Endoscopic fibrin glue injection for closure of pancreatocutaneous fistula following transgastric endoscopic necrosectomy
Ji Woong Jang, Do Hyun Park, Sung-Hoon Moon, Sang Soo Lee, Dong Wan Seo, Sung Koo Lee, Myung-Hwan Kim
Ji Woong Jang, Do Hyun Park, Sung-Hoon Moon, Sang Soo Lee, Dong Wan Seo, Sung Koo Lee, Myung-Hwan Kim, Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul 138-736, South Korea
Author contributions: Jang JW, and Park DH wrote the paper; Jang JW, Park DH, and Moon SH carried out the procedures; Park DH, Seo DW, Lee SK, and Kim MH advised and informed about the knowledge.
Correspondence to: Do Hyun Park, MD, PhD, Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, 388-1 pungnap-2dong, Songpagu, Seoul 138-736, South Korea. dhpark@amc.seoul.kr
Telephone: +82-2-30103194 Fax: +82-2-4760824
Received: June 10, 2008 Revised: August 30, 2008 Accepted: September 6, 2008 Published online: October 21, 2008
Abstract
Transgastric endoscopic necrosectomy has been recently introduced as the effective and alternative management of infected pancreatic necrosis and pancreatic abscess. However, up to 40% of patients who undergo endoscopic necrosectomy may need an additional percutaneous approach for subsequent peripancreatic fluid collection or non-resolution of pancreatic necrosis. This percutaneous approach may lead to persistent pancreatocutaneous fistula, which remains a serious problem and usually requires prolonged hospitalization, or even open-abdominal surgery. We describe the first case of pancreatocutaneous fistula and concomitant abdominal wall defect following transgastric endoscopic necrosectomy and percutaneous drainage, which were endoscopically closed with fibrin glue injection via the necrotic cavity.
