Use of Fibrin Sealant in the Treatment of Pancreatic Fistulas

Abstract

Since recently, fistulas have been seen as frequent and life-threatening complications of pancreatic surgery; moreover because they lengthen the hospitalization time, they are as costly for the patient as for the National Health Service. That is why there are surgeons who prefer total or near-total pancreatectomy instead of pancreatic anastomosis requiring operations as pancreatoduodenectomy (PD) [1]. Precise operative techniques and full preoperative control of nourishment should be considered in themselves as prevention against fistula formation. If fistula treatment is needed, proper drainage and washout, pharmacologic suppression of pancreatic secretion, and enteral or parenteral nutrition and antibiotics in the case of possible infection, should be used. Only in selected cases does surgical treatment appear to be advisable. In our experience with fistulas of the pancreas, all the above-mentioned nonsurgical procedures have been employed

in order to achieve straightness of course, flow reduction, and sterilization. When no rapid spontaneous fistula closure could be obtained, human fibrin sealant has been applied [2].