BACKGROUND: Fibrin glue was used in a various fields of surgery during the last 15 years, but its use has not been reported in bariatric surgery yet. METHODS: In 2 out of 215 morbidly obese patients who underwent vertical banded gastroplasty, a non-healing gastrocutaneus fistula (GCF) developed. In both patients sepsis occurred, caused by a leak of the posterior gastric wall, which was managed by means of an unsuccessful reoperation. After that, sepsis recurred, and a non-healing GCF developed. These GCF were managed endoscopically by the use of a fibrin sealant (Beriplast P 2 ml set, Behring) as a tissue adhesive. RESULTS: One injection was needed for the first case and six for the second in achieving full healing of the fistulas. No evidence of fistula was observed at gastroscopy 3 and 24 months after the end of therapy. CONCLUSIONS: Endoscopic use of human fibrin sealant is simple, safe, effective and in some cases life-saving. This is a therapeutic option in high output GCF in morbidly obese patients.
BACKGROUND: Fibrin glue was used in a various fields of surgery during the last 15 years, but its use has not been reported in bariatric surgery yet. METHODS: In 2 out of 215 morbidly obesepatients who underwent vertical banded gastroplasty, a non-healing gastrocutaneus fistula (GCF) developed. In both patientssepsis occurred, caused by a leak of the posterior gastric wall, which was managed by means of an unsuccessful reoperation. After that, sepsis recurred, and a non-healing GCF developed. These GCF were managed endoscopically by the use of a fibrin sealant (Beriplast P 2 ml set, Behring) as a tissue adhesive. RESULTS: One injection was needed for the first case and six for the second in achieving full healing of the fistulas. No evidence of fistula was observed at gastroscopy 3 and 24 months after the end of therapy. CONCLUSIONS: Endoscopic use of human fibrin sealant is simple, safe, effective and in some cases life-saving. This is a therapeutic option in high output GCF in morbidly obesepatients.
Authors: Mena Boules; Julietta Chang; Ivy N Haskins; Gautam Sharma; Dvir Froylich; Kevin El-Hayek; John Rodriguez; Matthew Kroh Journal: World J Gastrointest Endosc Date: 2016-09-16
Authors: Elisabeth Lippert; Frank H Klebl; Florian Schweller; Claudia Ott; Cornelia M Gelbmann; Jürgen Schölmerich; Esther Endlicher; Frank Kullmann Journal: Int J Colorectal Dis Date: 2010-12-29 Impact factor: 2.571
Authors: Ramon Vilallonga; José Manuel Fort; Oscar Gonzalez; Juan Antonio Baena; Albert Lecube; Josè Salord; Manel Armengol Carrasco; Josep Ramon Armengol-Miró Journal: Diagn Ther Endosc Date: 2010-06-20