Management of digestive fistulas.

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.