Endoscopic Closure Of Persistent Terminal Pancreatic Duct Leak Utilizing Fibrin Sealant

A 33-year-old female without prior medical history presented following a motor vehicle collision and resulting injuries including pancreatic and splenic lacerations requiring distal pancreatectomy and splenectomy. Her postoperative course was complicated by refractory surgical bed fluid collections despite percutaneous drainage. ERCP was performed and demonstrated contrast extravasation from the distal aspect of the pancreatectomy site. Sphincterotomy with plastic pancreatic duct stenting was performed, though intraperitoneal fluid with an amylase concentration of greater than 27,000 U/L continued to accumulate, and leak control via endoscopic deployment of fibrin sealant was planned.