title: Study on the use of T-tube for patients with persistent duodenal fistula: is it useful?
abstract: BACKGROUND
  The commonest surgical treatment used for peptic ulcer perforation is omental patching. If, however, the perforation leaks, it rarely heals by itself due to persistence of duodenal fistula (DF). We present our experience with a T-tube placed into the DF for better outcome of the patients.
  
  
  METHODS
  All patients in our hospital with DF following failure of surgery for duodenal perforation were included in this study. After identification of the perforation, a size 16 French T-tube was put in place. The patients were analyzed on basis of duration of hospital stay, complications related to the T-tube and overall complications, start of oral feeds, and follow-up.
  
  
  RESULTS
  In this 3-year study, ten patients with DF were admitted. The mean age was 50 years. The T-tube was kept in place within the fistula for 20.5 days. The mean duration to start oral feeds was 8.8 days. The mean duration of hospital stay was 23.2 days, and the mean follow-up period was 6.3 months. The complications observed in the postoperative period were fever in four patients, wound dehiscence in four patients, and peritoneal collection in two patients, all of which were managed easily. There was no peritubal leakage and no failure of surgery as regards placement of a T-tube. There were no deaths in this study.
  
  
  CONCLUSIONS
  Placement of a T-tube into a DF appears to be very effective procedure for managing this complication of surgical repair of a perforated peptic ulcer with an omental patch. The technique appears to be simple and rewarding. Further use of this method by other workers will substantiate our efforts.
authors: Department of Surgery, UP Rural Institute of Medical Sciences & Research, Saifai, Etawah, 206130, Uttar Pradesh, India.
authors: Vipin
authors: V
authors: Gupta
authors: Shailendra Pal
authors: SP
authors: Singh
authors: Anand
authors: A
authors: Pandey
authors: Rajesh
authors: R
authors: Verma
mesh_terms: D000328:Adult; D004322:Drainage / Q000295:instrumentation*; D004378:Duodenal Diseases / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology / Q000601:surgery*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010439:Peptic Ulcer Perforation / Q000150:complications*; D011183:Postoperative Complications; D011446:Prospective Studies; D016896:Treatment Outcome
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