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Surgical Endoscopy

, Volume 33, Issue 6, pp 1795–1801 | Cite as

Endoscopic plombage with polyglycolic acid sheets and fibrin glue for gastrointestinal fistulas

  • Yoshiko Nakano
  • Toshitatsu TakaoEmail author
  • Yoshinori Morita
  • Hiroya Sakaguchi
  • Shinwa Tanaka
  • Tsukasa Ishida
  • Takashi Toyonaga
  • Eiji Umegaki
  • Yuzo Kodama
Article
  • 269 Downloads

Abstract

Background and study aims

Gastrointestinal (GI) fistulas arise as adverse events of GI surgery and endoscopic treatment as well as secondary to underlying diseases, such as ulceration and pancreatitis. Until a decade ago, they were mainly treated surgically or conservatively. Bioabsorbable polyglycolic acid (PGA) sheets and fibrin glue, which are commonly used in surgical procedures, have also recently been used in endoscopic procedures for the closure of GI defects. However, there have only been few case reports about successful experiences with this approach. There have not been any case-series studies investigating the strengths and weaknesses of such PGA sheet-based treatment. In this study, we evaluated the clinical effectiveness of using PGA sheets to close GI fistulas.

Patients and methods

Cases in which patients underwent endoscopic filling with PGA sheets and fibrin glue for GI fistulas at Kobe University Hospital between January 2013 and April 2018 were retrospectively reviewed.

Results

A total of 10 cases were enrolled. They included fistulas due to leakage after GI surgery, aortoesophageal/bronchoesophageal fistulas caused by chemoradiotherapy, or severe acute pancreatitis. The fistulas were successfully closed in 7 cases (70%). The unsuccessful cases involved a fistula due to leakage after surgical esophagectomy and bronchoesophageal fistulas due to chemoradiotherapy or severe acute pancreatitis. Unsuccessful treatment was related to fistula epithelization.

Conclusion

Endoscopic plombage with PGA sheets and fibrin glue could be a promising therapeutic option for GI fistulas.

Keywords

Fistula Polyglycolic acid sheet Fibrin glue 

Notes

Compliance with ethical standards

Disclosures

Dr. Nakano, Dr. Takao, Dr. Morita, Dr. Sakaguchi, Dr. Tanaka, Dr. Ishida, Dr. Toyonaga, Dr. Umegaki, and Dr. Kodama have no conflicts of interest to disclose.

Supplementary material

Supplementary material 1 (MP4 21881 KB)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Yoshiko Nakano
    • 1
  • Toshitatsu Takao
    • 1
    Email author
  • Yoshinori Morita
    • 1
  • Hiroya Sakaguchi
    • 1
  • Shinwa Tanaka
    • 1
  • Tsukasa Ishida
    • 1
  • Takashi Toyonaga
    • 2
  • Eiji Umegaki
    • 1
  • Yuzo Kodama
    • 1
  1. 1.Division of Gastroenterology, Department of Internal MedicineKobe University Graduate School of MedicineKobeJapan
  2. 2.Department of EndoscopyKobe University HospitalKobeJapan

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