MANAGEMENT OF DUODENAL FISTULA BY INTRALUMINAL CONTINOUS ASPIRATION
ADİL TANIK1, İLHAMİ TANER KALE1, MEHMET AYHAN KUZU1, BİROL BOSTANCI1, UĞUR YILMAZ2
1Ankara Numune Hastanesi 1. Cerrahi Kliniği, ANKARA
2Yüksek İhtisas Hastanesi Gastroenteroloji Bölümü, ANKARA
Duodenal fistula has a high morbidity and mortality rates due to uncontrolled sepsis, high output, malnutrition and multiple operations. Most of these patients are not good candidates for another operation. We report a modified approach to the conservative management of duodenal fistulas with continuous intraluminal aspiration. Double lumen catheter was inserted at the level of duodenal fistula with the aid of a flexible gastroscope. This technique was used in five patients. The output of duodeno-cutaneous fistula was significantly decreased on the first day following the intraluminal continuous aspiration (the mean fistula output was 2450 ml before the continuous aspiration vs 725 ml afterwards, p<0.01 ) and continued to decreased progressively thereafter. Mean time for fistula closure after continuous intraluminal aspiration was 13 (7-17) days. This simple technique is effective in preventing complications due to duodenal fistula.
Keywords: DUODENAL FISTULA, CONSERVATIVE MANAGEMENT, INTRALUMINAL ASPIRATION