Finally it should be noted that these agents have became an additional tool for treating complex hemorrhaging and gastrointestinal fistula in selected patients. However, they are not the first option for gastric and duodenal ulcer treatment for which sclerosants and mechanical and thermal methods are most common. 3. Sachdeva AK, Loiacano LA, Amiel GE, et al. Variability of clinical residents entering training programs in surgery. Surgery 1995; 118: 300-308. 4. Holcomb JB, Pusateri AE, Hess JR, et al. Implications of new fibrin sealant technology for trauma surgery. Surg Clin North Am 1999; 77: 943-952. 5. Spotnitz WD, Welker RL. Clinical uses of fibrin sealant. En: Mintz PD, ed. Transfusion Therapy: Clinical Principles and Practice. Bethesda: AABB Press 2000. p. 199-221. 6. Joch C, Witzke G, Groner A, et al. Clinical safety of fibrin sealants. Presented at the IXth World Conference of Cardio-Thoracic Surgeons, November 14-17, 1999, Lisboa, Portugal. 7. Pankaj S, Mankad M, et al. The role of fibrin sealants in hemostasis. The American journal of surgery 2001; 182: 21s-28s. 8. Mackie IJ. The biology of haemostasis and thrombosis. En: weatherall DJ, Ledingham JGG, Warrell DA. Eds Oxford Textbook of medicine, 3rd ed. Oxford: Oxford University press 1996. p. 3613-27. 10. Andress HJ, Mewes A, Lange V. Endoscopic hemostasis of a bleeding diverticulum of the sigma with fibrin sealant Endoscopy 1993; 252: 193. 11. Kubba AK, Lessells A, Palmer KR. Experimental studies of injection therapy for ulcer haemorrhage in rabbits Br J Surg 1997; 844: 551-554. 12. Lange V, Maiwald G, Souvatzi T, Meyer G. Endoscopic approaches for occlusion of fistulas. En Schlang G, Wayand W eds. Fibrin Sealing in Surgical and Nonsurgical Fields: Endoscopy. Berlin, Springer 1995. p. 58-64. 13. Akhras J, Tobi M, Zagnoon A. Endoscopic fibrin sealant injection with application of hemostatic clips: a novel method of closing a refractory gastrocutaneous fistula. Dig Dis Sci 2005; 5010: 1872-1874. 14. Biblioteca Cochrane Plus ISSN 1745-9990. De La Biblioteca Cochrane Plus, número 2, 2008. Oxford, Update Software Ltd. 15. Goh P, Kum M, Toh E. Endoscopic patch closure of malignant esophagotracheal fistula using Histoacryl glue. Surg Endosc 1994; 1434-1435. 16. Lucantoni R, Cicconi M, Mestichelli A, Moretti V, Colombati M. Use of fibrin tissue adhesive Tissucol in Mallory-Weiss syndrome. G Chir 1989; 106: 330-2.
Antes de terminar es importante resaltar que estos agentes se convierten en una herramienta más en el manejo de las hemorragias complejas y fístulas del tracto gastrointestinal en pacientes adecuadamente escogidos, sin embargo, no son la primera elección para las úlceras gástricas o duodenales, para lo cual existen los agentes esclerosantes y los métodos mecánicos y térmicos conocidos por todos.