Early endoscopic fibrin sealing of high-output postoperative enterocutaneous fistulas

In seven patients with high-volume enterocutaneous fistula following gastric surgery, a new method of treatment was used. Fibrin tissue adhesive was applied transintestinally under endoscopic guidance, in one or multiple sessions, to occlude the anastomotic dehiscence and the perianastomotic cavity. Fistula output diminished rapidly in all cases, and complete closure was endoscopically confirmed. There were no complications related to the method. Because of the simplicity and safety of this procedure compared with the complexity of surgical treatment and the persistently high mortality associated with conservative management, interventional endoscopic approach is suggested as an option for treatment of high-volume alimentary fistula.