title: Cholecystoduodenoplasty for high-output duodenal fistula.
abstract: External duodenal fistulae from sutured duodenal ulcer perforation sites are difficult to manage and most patients succumb to septicemia and undernutrition. This is due to failure of closure of the perforation site in the duodenum. Most techniques described in the past to facilitate closure have failed to give satisfactory results. We have devised a new procedure where the duodenal ulcer perforation is closed by mobilizing the gall bladder. A hole is made in the fundus of the gall bladder and it is anastomosed to the freshened edges of the duodenal opening. We have treated six patients by this technique. In five patients the leak was satisfactorily sealed. Three patients died - one due to persistent leak and two due to jejunostomy leak.
authors.affiliation: Department of Gastroenterology Surgical Services, Seth G S Medical College and K E M Hospital, Mumbai.
authors.forename: O S
authors.initials: OS
authors.lastname: Rohondia
authors.forename: R D
authors.initials: RD
authors.lastname: Bapat
authors.forename: S
authors.initials: S
authors.lastname: Husain
authors.forename: P G
authors.initials: PG
authors.lastname: Shriyan
authors.forename: R
authors.initials: R
authors.lastname: Pradhan
authors.forename: K S
authors.initials: KS
authors.lastname: Kumar
mesh_terms: D000714:Anastomosis, Surgical; D016154:Digestive System Fistula / Q000209:etiology / Q000601:surgery*; D004381:Duodenal Ulcer / Q000150:complications; D004386:Duodenum / Q000601:surgery*; D005704:Gallbladder / Q000601:surgery; D006801:Humans; D010439:Peptic Ulcer Perforation / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome