Background: Postoperative fistulas are not a rare complication of the gastrointestinal surgery, but there is no general agreement on when and how to treat them. Patients and Methods: All 32 postoperative digestive fistulas treated during the last six years were retrospectively reviewed. They included 9 internal fistulas: (three recto-vesical, five recto-vaginal and one high-output pleuro-esophagic fistulas); and 23 external fistulas (six low output oesophageal or gastrocutaneous fistulas following esophagogastric surgery, seven low-output and two high-output enterocutaneous fistulas following low anterior resection for rectal cancer, five low-output enterocutaneous fistulas following left and subtotal colectomies for colonic cancer, diverticulitis or actinic sigmoid stenosis, and finally three low-output fistulas appeared after restoration of intestinal continuity following Hartmann's procedure. Patients were endoscopied following conservative treatment failure after at leat 10-15 days of treatment. Once the fistula was located, 2-4 ml of reconstituted fibrin glue (Tissucol 2.0) at 37°C was endoscopically injected through a duplocath catheter. Results: Pts were 55 SD15 y-o (32-87) and 65% were men.28 % of the pts had an internal fistula. 78% of the fistulas were low-output fistula. We were able to find out the inner fistular orifices in 100% of the cases. The fistular orifices were always located near the surgical anastomosis. The mean healing time was 17 SD18 days (4-90). It was needed an average of 2.8 SD2 sessions per patient (1-5) to seal the fistula, but only 2.3 in those pts who responded. The complete closure of the fistula was achieved in 75%; (80% of the low-output, 50% of the high-output and 44% of the internal recto-vaginal or recto-vesical fistulas.Only one previously sealed fistula reopened after a follow up ranging from 2 to 36 months. No complications related with the procedure were found. Mortality was 9.4% (three out of 32), but hardly was the mortality related with the persistence of the fistula and clinical deterioration in two patient (6.2%). Summary: Postsurgical gastrointestinal fistula should be endoscopically treated using biological fibrin glue: we succeeded in achieving the fistular closure in 75% of the cases, especially for low output enterocutaneous fistulas. We believe that endoscopic fistular treatment is safe, and should be tried as soon as possible (after a failed conservative treatment of 10-14 days) to cut the patient hospital stay in at leat 75% of cases. Background: Postoperative fistulas are not a rare complication of the gastrointestinal surgery, but there is no general agreement on when and how to treat them. Patients and Methods: All 32 postoperative digestive fistulas treated during the last six years were retrospectively reviewed. They included 9 internal fistulas: (three recto-vesical, five recto-vaginal and one high-output pleuro-esophagic fistulas); and 23 external fistulas (six low output oesophageal or gastrocutaneous fistulas following esophagogastric surgery, seven low-output and two high-output enterocutaneous fistulas following low anterior resection for rectal cancer, five low-output enterocutaneous fistulas following left and subtotal colectomies for colonic cancer, diverticulitis or actinic sigmoid stenosis, and finally three low-output fistulas appeared after restoration of intestinal continuity following Hartmann's procedure. Patients were endoscopied following conservative treatment failure after at leat 10-15 days of treatment. Once the fistula was located, 2-4 ml of reconstituted fibrin glue (Tissucol 2.0) at 37°C was endoscopically injected through a duplocath catheter. Results: Pts were 55 SD15 y-o (32-87) and 65% were men.28 % of the pts had an internal fistula. 78% of the fistulas were low-output fistula. We were able to find out the inner fistular orifices in 100% of the cases. The fistular orifices were always located near the surgical anastomosis. The mean healing time was 17 SD18 days (4-90). It was needed an average of 2.8 SD2 sessions per patient (1-5) to seal the fistula, but only 2.3 in those pts who responded. The complete closure of the fistula was achieved in 75%; (80% of the low-output, 50% of the high-output and 44% of the internal recto-vaginal or recto-vesical fistulas.Only one previously sealed fistula reopened after a follow up ranging from 2 to 36 months. No complications related with the procedure were found. Mortality was 9.4% (three out of 32), but hardly was the mortality related with the persistence of the fistula and clinical deterioration in two patient (6.2%). Summary: Postsurgical gastrointestinal fistula should be endoscopically treated using biological fibrin glue: we succeeded in achieving the fistular closure in 75% of the cases, especially for low output enterocutaneous fistulas. We believe that endoscopic fistular treatment is safe, and should be tried as soon as possible (after a failed conservative treatment of 10-14 days) to cut the patient hospital stay in at leat 75% of cases.