Clinical Features and Therapeutic Management of Postoperative Eso-Gastro-Duodenal Fistulas – A 6-Year Retrospective Study

Abstract

The postoperative digestive fistula is the most feared complication of gastrointestinal surgeries. We performed a retrospective study over a period of 6 years, in which we included 28 patients who developed postoperative esophageal, gastric or duodenal fistulae in the General Surgery Department of “Bagdasar–Arseni” Emergency Hospital. We assessed the risk factors for this complication, its management and its results. Most patients were males and the mean age was 61.1 years. For 15 patients, the surgeries were required for benign lesions while the rest of 13 patients had malignant disease. Regarding the type of the fistula, 14 were duodenal stump fistulas, 13 were anastomotic leakages and one was a dehiscence of a sutured duodenal ulcer. Six cases required emergency relaparotomy for sepsis and peritonitis. Sixteen patients had a favourable outcome while death occurred in 12 cases. The mortality was higher for patients with sepsis and peritonitis as the first clinical manifestations of fistula and with the need for an emergency reoperation.