This retrospective study analyzed the management options and outcomes of 50 adult patients with complex duodenal fistulas. Surgical closure combined with duodenal decompression yielded the highest success rate, with 76% of patients achieving fistula closure. In selected cases, nonoperative management was attempted, resulting in closure without surgery in 5 out of 6 patients. However, eventually failed nonoperative management led to a significant difference in fistula closure rates. The overall in-hospital mortality rate was 40%.
Research Support, Non-U.S. Gov’t by Leppäniemi A, Tolonen M and Mentula P in World J Emerg Surg
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