De Backer A, Fetelian D, Carpentier Y, Willems G
Acta Chir Belg. 1985 May-Jun;85(3):185-91.
A series of 23 patients-15 with a spontaneous postoperative duodenal fistula and 8 with a catheter duodenostomy fistula-admitted in both departments between 1974 and 1983, is reviewed. Overall mortality rate was 9%. Using conservative management and parenteral nutrition, spontaneous closure of the fistula was observed in 78% of the cases after an average duration of 33 days. Three patients with an intractable fistula were successfully managed by surgical internal drainage using a Roux-en-Y jejunal loop. Healing time of catheter duodenostomy fistulas was similar to that of spontaneous fistulas. Therefore, deliberate creation of such duodenal fistulas should be carefully considered. The Roux-en-Y operation is recommended for those fistulas that do not heal with conservative management. The latter technique could perhaps be used primarily for the closure of difficult duodenal stumps.
回顾了1974年至1983年间两个科室收治的23例患者，其中15例为术后自发性十二指肠瘘，8例为导管十二指肠造口瘘。总体死亡率为9%。采用保守治疗和肠外营养，78%的病例在平均33天后瘘口自行闭合。3例顽固性瘘患者通过使用Roux-en-Y空肠袢进行手术内引流成功治愈。导管十二指肠造口瘘的愈合时间与自发性瘘相似。因此，应谨慎考虑有意制造此类十二指肠瘘。对于保守治疗不愈合的瘘，建议采用Roux-en-Y手术。后一种技术或许可主要用于闭合困难的十二指肠残端。
