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