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Management of digestive fistulas
D Ysebaert1, R Van Hee, G Hubens
1Dept. of Surgery, University Hospital Antwerp, Belgium.
Background:
The efficacy of total parenteral nutrition and somatostatin was assessed in reducing output and promoting spontaneous closure of postoperative digestive fistulas.
Methods:
In a consecutive series of 23 patients, closure was achieved in 83% of patients after a mean fistula duration of 11.0 +/- 7.9 days and a mean of 13.2 +/- 7.0 days of drug treatment, and without mortality.
Results:
A marked first-day effect (output drop > 50%) was noted in 60% of patients and had a good prognosis. Infection of the fistula markedly prolonged fistula closure time, but did not affect total outcome.
Conclusion:
Somatostatin has been shown to be very useful in the conservative treatment of digestive fistulas because of its ability to reduce output significantly and to accelerate spontaneous closure.