Treatment of postoperative external duodenal fistula using roux-en-y jejunal loop

ABSTRACT

postoperative external duodenal fistulae are associated with significant mortality and morbidity. Although medical management is followed by closure of fistulae in up to 90% of patients, mortality and mortality rates are sill high among those who would not respond to this treatment. In addition, there is no technical recommendation as regards the surgical intervention as each operative procedure has its own limitations, mortality and morbidity. to evaluate the outcome of using Roux-en-Y jejunal loop for closure and drainage of postoperative external high-output duodenal fistulae. a series of prospective cases from March 1993 to February 1998. Department of Surgery, Faculty of Medicine, Zagazig University. seventeen patients with postoperative external duodenal fistulae, in whom surgical intervention was indicated, were treated using Roux-en-Y jejunal loop anastomosed to the fistula stoma. four patients [23.5%] died in the early postoperative period [30 days]. Morbidity was related to chest infections, intraabdominal infections, multiorgan failure and burst abdomen with a total major complications rate of 58.8%. the Roux-en-Y operation is recommended for difficult fistulae that do not heal with medical management. It is a safe one-stage procedure that is suitable for high-risk patients