Incidence of Pancreatic Fistula after using N-butyl-2-Cyanoacylate Glue for Pancreaticojejunostomy Anastomosis after Pancreatoduodenectomy in Rajavithi Hospital
Wipawee Inthasotti MD*, Sa-ard Teepongkaruna MD*, Kittipong Chaibut MD*, Jumpol Singhirunusorn MD*, Somboon Subwongcharoen MD*, Nattaya Direksil MD*
Affiliation : * Department of Surgery, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
Background : Pancreatic fistula remains a common occurrence after pancreatiocoduodenectomy (PD). There is no consensus
on which options should be used to reduce its incidence.
Objective : To assess the efficacy of N-butyl-2-cyanoacylate glue (Histovicryl) in reducing pancreatic fistula after PD.
Material and Method: This was a prospective study conducted between 2015 and 2017 at Rajavithi Hospital, of 67
consecutive patients who underwent PD with pancreatojejunostomy. Patients were divided into two groups, with 25 patients
in the N-butyl-2-cyanoacylate glue group and 42 patients in the control group. Postoperative pancreatic fistula was assessed
after the third postoperative day.
Results : Pancreatic fistula was diagnosed in eleven patients (16%): two (8%) in the N-butyl-2-cyanoacylate glue group and
9 (21.4%) in the control group. There were no significant differences between the groups, and no patients in the present study
died from pancreatic fistula-related complications.
Conclusion : The present study demonstrated that applying N-butyl-2-cyanoacrylate to pancreaticenteric anastomosis after
PD may reduce the incidence of pancreatic fistula.
Keywords : N-butyl-2-cyanoacylate glue, pancreatic fistula, pancreatoduodenectomy, whipple operation, pancreatic anastomosis
