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Biliogastric Diversion for the Management of High-Output Duodenal Fistula: Report of Two Cases and Literature Review

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

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.

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Authors and Affiliations

  1. 2nd Surgical Department, 424 General Military Hospital, Thessaloniki, Greece

    Konstantinos Milias

  2. 3rd Surgical Department, AHEPA University Hospital, Thessaloniki, Greece

    Nikolaos Deligiannidis, Theodossis S. Papavramidis & Spiros Papavramidis

  3. 1st Surgical Department, 424 General Military Hospital, Thessaloniki, Greece

    Konstantinos Ioannidis

  4. Surgical Department, 404 General Military Hospital, Larisa, Greece

    Nikolaos Xiros

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  1. Konstantinos Milias
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  2. Nikolaos Deligiannidis
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  3. Theodossis S. Papavramidis
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  4. Konstantinos Ioannidis
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  6. Spiros Papavramidis
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Correspondence to Konstantinos Milias.

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Milias, K., Deligiannidis, N., Papavramidis, T.S. et al. Biliogastric Diversion for the Management of High-Output Duodenal Fistula: Report of Two Cases and Literature Review. J Gastrointest Surg 13, 299–303 (2009). https://doi.org/10.1007/s11605-008-0677-6

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