Endoscopic Fibrin Sealing of High-output Non- healing Gastrocutaneous Fistulas after Vertical Gastroplasty in Morbidly Obese Patients

Abstract

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.

Management of enterocutaneous fistulae: A 10 years experience

“…Our institutional use of wound VAC for ECF patients was limited to three cases and showed success in all. Similarly, fibrin glue has been used as a sealant to aid fistula closure [7] . We used fibrin glue in three patients, and it helped in closure in all three.…”

“…Spontaneous closure rate of ECF is small and persistent fistulae do need definitive surgery. Newer therapies including wound vacuum-assisted closure (VAC), fibrin glue and the use of somatostatin analogues have been used to promote the closure of ECF [6][7][8] . The objective of this study was to evaluate the trend in the management of ECF in a community teaching hospital and to compare the outcomes of conservative versus surgical management.…”

Endoscopic treatment of Roux-en-Y gastric bypass-related gastrocutaneous fistulas using a novel biomaterial

“…For the remaining five patients, surgical reversal was necessary for treatment. Case studies in the literature report the use of endoscopic clips and fibrin sealant to treat RGYB-related postoperative fistulas [13][14][15][16][17][18][19][20]. Although success with endoscopic application of fibrin sealant and glue applied in the orifice of gastrocutaneous fistulas has been previously reported in the literature, as many as nine endoscopic sessions were necessary for effective closure of the fistula.…”

Laparoscopic Management of Chronic Pouch Fistula After a Leak Following Staple Line Dehiscence After Laparoscopic Revision of a Dilated Pouch Following Roux-en-Y Gastric Bypass

“…The majority of fistulae will resolve with conservative management [28]. Successful outcome after endoscopic injection of fibrin sealant into gastrojejunal, gastrogastric, and gastrocutaneous fistulous tracts has been described in isolated case series [33][34][35]. Other endoscopic methods for closure of chronic gastric leaks after RYGB have been used with a combination of argon plasma coagulation for mucosal ablation around the rim of the fistula to promote fusion, endoclips, fibrin glue, and removable covered plastic stent insertion [36].…”