Management of Digestive Fistulas

Abstract

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.