SUPERGLUE IN GI LEAKS: USE OF CYANOACRYLATE GLUE IN GI FISTULAE
Abstract
Background and Aims: Gastro-Intestinal Fistulae (GIF) on most occasions are iatrogenic and come with significant morbidity and myriad of presentations from asymptomatic individuals to severe sepsis. About a third of GIF heal but most require repeated surgeries adding to the morbidity. We evaluated the feasibility of cyanoacrylate glue injection in the management of non-healing GIF which had failed conservative management of nutrition, antibiotics, and percutaneous drainage.
Methods: Seven patients of non-healing GIF were managed with CAG injection by a sclerotherapy needle via an upper GI endoscopy. The primary endpoint was the closure of the fistula. Feasibility of the procedure was defined as the possibility to reach the opening of the GIF and perform the glue injection. The other parameters noted were the number of injections required the time to achieve complete closure of the fistula and other complications
Results: Feasibility of the procedure was 100%. A median of 01 injections (Range 1-2) was performed in the patients with 71.4% requiring only one injection. The success rate was 100%. The average time required for GIF closure was 8.5 + 3.9 days (range 02-13 days). There were no complications noted in the study. All the patients were followed up for 12 weeks and no mortality was recorded.
Conclusions: Endoscopic injection of CAG appears to be a safe, feasible, reliable and effective modality which offers a minimally invasive technique as an alternative to surgical reoperation in patients with accessible GIFs that are non-healing after standard management
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References
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