부산대학교 도서관

A 81-year-old man underwent total gastrectomy for type 4 gastric cancer from the gastric body to the antrum. A postoperative pancreatic fistula was confirmed by fistulography to be connected to the esophagojejunostomy stump on post operative day (POD) 28 and also to the common bile duct at the next day's examination. We implemented conservative therapy using somatostatin analog and blood coagulating XIII factor, but found no effect for closing the fistula. On POD 58, fistulography showed the fistula connected to the duodenal stump, and fibrin glue injection into the fistula, closing it. He was discharged on POD 82. In our experience, fibrin glue injection has moved very useful in closing persistent postoperative pancreatic fistulas.