Biliogastric diversion for the management of high-output duodenal fistula: report of two cases and literature review.
High-output duodenal fistula occurs as a result of a duodenal wall defect caused by gastroduodenal surgery, endoscopic sphincterotomy, duodenal injury, and tumors with high morbidity and mortality rate. A new technique for its management is reported along with literature review. This procedure consists of transection of the duodenum 2 cm distally to the pylorus, transection of the common bile duct, and end duodenostomy with or without suturing the duodenal wall defect. The continuity of the alimentary tract is reinstated by an end-to-end duodenojejunostomy, end-to-side choledochojejunostomy, and end-to-side Roux-en-Y jejunojejunostomy, obtaining biliogastric diversion from the duodenum and closure of the fistula. This technique was performed in two patients with excellent results.
Milias
Konstantinos
K
2nd Surgical Department, 424 General Military Hospital, Thessaloniki, Greece. konmil@med.auth.gr
Deligiannidis
Nikolaos
N
Papavramidis
Theodossis S
TS
Ioannidis
Konstantinos
K
Xiros
Nikolaos
N
Papavramidis
Spiros
S
D000713:Anastomosis, Roux-en-Y; D002768:Choledochostomy; D004378:Duodenal Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D004385:Duodenostomy; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D007582:Jejunostomy; D008297:Male; D013536:Suture Techniques