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Related Experiment Videos

External biliary-pancreatic fistulas.

M Zer, M Dintsman

    International Surgery
    |March 1, 1977
    PubMed
    Summary
    This summary is machine-generated.

    This study on pancreatic and biliary-cutaneous fistulas found spontaneous healing in 81% of conservative treatments. Surgical intervention for high-output fistulas is best delayed, with Roux-en-Y fistulojejunostomy as the preferred method.

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    Area of Science:

    • Gastroenterology
    • Surgical Gastroenterology
    • Hepatobiliary Surgery

    Background:

    • Pancreatic and biliary-cutaneous fistulas present significant management challenges.
    • Outcomes vary based on fistula type (low-output vs. high-output) and treatment approach.

    Purpose of the Study:

    • To review outcomes of patients treated for pancreatic and/or biliary-cutaneous fistulas.
    • To compare conservative versus surgical management strategies.
    • To identify factors influencing fistula healing and patient prognosis.

    Main Methods:

    • Retrospective review of 27 patients treated for pancreatic and/or biliary-cutaneous fistulas.
    • Analysis of treatment outcomes, including spontaneous sealing rates, surgical success, mortality, and complications.

    Related Experiment Videos

  • Categorization of fistulas into low-output (LO) and high-output (HO) types.

    • Main Results:

    • Spontaneous fistula sealing occurred in 81% of conservatively treated cases (48% overall).
    • LO fistulas had higher spontaneous sealing rates than HO fistulas (100% vs. 68% conservatively).
    • Surgical intervention in 11 patients resulted in 3 deaths and 3 failures; all deaths occurred in HO fistula patients operated on within 3 months.

    Conclusions:

    • A significant difference in prognosis exists between LO and HO fistulas.
    • Conservative management is favored for LO fistulas, with surgery reserved for those persisting over a year.
    • For HO fistulas requiring surgery, a delay of at least three months is recommended; Roux-en-Y fistulojejunostomy is the preferred procedure.