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To assess the long term outcome of utilising fibrin glue in the treatment of this disease.A chart review and telephone interview of patients who underwent fibrin glue instillation for complex cryptogenic fistulae had successful healing and 6 months follow up was undertaken to establish long term follow up.Sixty patients participated in the initial trial of which 32 were considered successful at 6 months. We have managed to locate 23 (72%) of those patients. At a mean follow up of 6.5 years, 17 (74%) patients remained disease free, 6 (26%) patients had variable degree of recurrence, four of which needed further surgical intervention. Recurrent disease occurred at an average of 4.1 years from surgery and on several occasions was at a different location in the perianal region. None of the patients suffered from incontinence.Short term success of fibrin glue in the treatment cryptogenic perianal fistulae ispredictive of long term healing but a quarter may develop recurrent symptoms in the long run. Injection of fibrin glue remains a safe, simple and durableprocedure and maypreclude extensive surgery.