LAPAROSCOPIC TREATMENT OF BILIODIGESTIVE FISTULAS

In about 800 endoscopic operations we found 12 patients with 14 biliod igestive fistulas, including cholecystocolonic, jejunal, duodenal and gastric fistulas. The treatment of eight patients has performed by lap aroscopic technique. After surgical exposure the following interventio ns are recommended: Lock with the Roder-loop or ligature with extracor poral knot, cover with Endo-GIA and manual seam. Fibrin-sticking is a complementary application. The simple or double Roder-loop is the simp lest variant, but not possible in all cases. If the closure is insecur e or if there is partial damage to the wall, the treatment can be comp lemented by fibrin-sticking or a manual seam. If the base of the fistu la is wide, we recommend ligation of the fistula at its base of the ap plication of an Endo-GIA after sufficient preparation. The preparation and representation of the dorsal wall is important.