MANAGEMENT OF DIGESTIVE FISTULAS

Background: The efficacy of total parenteral nutrition and somatostati n 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 fis tula 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 eff ect (output drop >50%) was noted in 60% of patients and had a good pro gnosis. Infection of the fistula markedly prolonged fistula closure ti me, but did not affect total outcome. Conclusion: Somatostatin has bee n shown to be very useful in the conservative treatment of digestive f istulas because of its ability to reduce output significantly and to a ccelerate spontaneous closure.