Management of Anastomotic Leakage after Gastrointestinal Surgery Using Fluoroscopy-guided Foley Catheter

ABSTRACT

PURPOSE: The aim of this study is to present cases of postoperative leakage after various types of gastrointestinal operations that were successfully managed with fluoroscopy-guided Foley catheter. METHODS: Fluoroscopy-guided Foley catheter insertion and drainage methods were performed in 13 leakage sites of 10 patients diagnosed as having leakage after gastrointestinal operations such as esophagectomy, gastrectomy and appendectomy. Under fluoroscopic guidance, a guide-wire was inserted into the leakage site where a Foley catheter was then introduced over the guide wire, inserted and ballooned. RESULTS: The median time for the procedures was 30 minutes (range 20~260 minutes), with esophagus or stomach leakage sites requiring a longer procedure time than the appendiceal or duodenal stump. The indwelling Foley catheters were successfully removed after a median of 11 days (range 8~44 days), and the opening of the enterocutaneous fistulas were spontaneously closed in eight out of 10 patients. CONCLUSION: The application of this method showed good results and could be a useful method to manage leakage after gastrointestinal surgery, especially in patients with leakage from the stump of the duodenum or appendix.