• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of gutGutCurrent TOCInstructions to authors
Gut. Dec 2001; 49(Suppl 4): iv21–iv28.
PMCID: PMC1766894

Optimising the treatment of upper gastrointestinal fistulae

Full Text

The Full Text of this article is available as a PDF (163K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Fischer JE. The pathophysiology of enterocutaneous fistulas. World J Surg. 1983 Jul;7(4):446–450. [PubMed]
  • Galland RB, Spencer J. Radiation-induced gastrointestinal fistulae. Ann R Coll Surg Engl. 1986 Jan;68(1):5–7. [PMC free article] [PubMed]
  • Patrick CH, Goodin J, Fogarty J. Complication of prolonged transpyloric feeding: formation of an enterocutaneous fistula. J Pediatr Surg. 1988 Nov;23(11):1023–1024. [PubMed]
  • Schein M. Free perforation of benign gastrojejunocolic and gastrocolic fistula. Report of two cases. Dis Colon Rectum. 1987 Sep;30(9):705–706. [PubMed]
  • Rubin SC, Benjamin I, Hoskins WJ, Pierce VK, Lewis JL., Jr Intestinal surgery in gynecologic oncology. Gynecol Oncol. 1989 Jul;34(1):30–33. [PubMed]
  • Lindberg E, Järnerot G, Huitfeldt B. Smoking in Crohn's disease: effect on localisation and clinical course. Gut. 1992 Jun;33(6):779–782. [PMC free article] [PubMed]
  • Coia LR, Myerson RJ, Tepper JE. Late effects of radiation therapy on the gastrointestinal tract. Int J Radiat Oncol Biol Phys. 1995 Mar 30;31(5):1213–1236. [PubMed]
  • Berry SM, Fischer JE. Classification and pathophysiology of enterocutaneous fistulas. Surg Clin North Am. 1996 Oct;76(5):1009–1018. [PubMed]
  • Donner CS. Pathophysiology and therapy of chronic radiation-induced injury to the colon. Dig Dis. 1998 Jul-Aug;16(4):253–261. [PubMed]
  • Yeo CJ, Cameron JL, Sohn TA, Lillemoe KD, Pitt HA, Talamini MA, Hruban RH, Ord SE, Sauter PK, Coleman J, et al. Six hundred fifty consecutive pancreaticoduodenectomies in the 1990s: pathology, complications, and outcomes. Ann Surg. 1997 Sep;226(3):248–260. [PMC free article] [PubMed]
  • Warshaw AL, Swanson RS. Pancreatic cancer in 1988. Possibilities and probabilities. Ann Surg. 1988 Nov;208(5):541–553. [PMC free article] [PubMed]
  • Foster CE, 3rd, Lefor AT. General management of gastrointestinal fistulas. Recognition, stabilization, and correction of fluid and electrolyte imbalances. Surg Clin North Am. 1996 Oct;76(5):1019–1033. [PubMed]
  • Thomas HA. Radiologic investigation and treatment of gastrointestinal fistulas. Surg Clin North Am. 1996 Oct;76(5):1081–1094. [PubMed]
  • McLean GK, Mackie JA, Freiman DB, Ring EJ. Enterocutaneous fistulae: interventional radiologic management. AJR Am J Roentgenol. 1982 Apr;138(4):615–619. [PubMed]
  • Foley MJ, Ghahremani GG, Rogers LF. Reappraisal of contrast media used to detect upper gastrointestinal perforations: comparison of ionic water-soluble media with barium sulfate. Radiology. 1982 Jul;144(2):231–237. [PubMed]
  • Zinner MJ, Baker RR, Cameron JL. Pancreatic cutaneous fistulas. Surg Gynecol Obstet. 1974 May;138(5):710–712. [PubMed]
  • Segal I, Parekh D, Lipschitz J, Gecelter G, Myburgh JA. Treatment of pancreatic ascites and external pancreatic fistulas with a long-acting somatostatin analogue (Sandostatin). Digestion. 1993;54 (Suppl 1):53–58. [PubMed]
  • Prinz RA, Pickleman J, Hoffman JP. Treatment of pancreatic cutaneous fistulas with a somatostatin analog. Am J Surg. 1988 Jan;155(1):36–42. [PubMed]
  • Pederzoli P, Bassi C, Falconi M, Albrigo R, Vantini I, Micciolo R. Conservative treatment of external pancreatic fistulas with parenteral nutrition alone or in combination with continuous intravenous infusion of somatostatin, glucagon or calcitonin. Surg Gynecol Obstet. 1986 Nov;163(5):428–432. [PubMed]
  • Spiliotis J, Vagenas K, Panagopoulos K, Kalfarentzos F. Treatment of enterocutaneous fistulas with TPN and somatostatin, compared with patients who received TPN only. Br J Clin Pract. 1990 Dec;44(12):616–618. [PubMed]
  • Sitges-Serra A, Jaurrieta E, Sitges-Creus A. Management of postoperative enterocutaneous fistulas: the roles of parenteral nutrition and surgery. Br J Surg. 1982 Mar;69(3):147–150. [PubMed]
  • Soeters PB, Ebeid AM, Fischer JE. Review of 404 patients with gastrointestinal fistulas. Impact of parenteral nutrition. Ann Surg. 1979 Aug;190(2):189–202. [PMC free article] [PubMed]
  • Dudrick SJ, Maharaj AR, McKelvey AA. Artificial nutritional support in patients with gastrointestinal fistulas. World J Surg. 1999 Jun;23(6):570–576. [PubMed]
  • Lipsett PA, Cameron JL. Internal pancreatic fistula. Am J Surg. 1992 Feb;163(2):216–220. [PubMed]
  • Rubelowsky J, Machiedo GW. Reoperative versus conservative management for gastrointestinal fistulas. Surg Clin North Am. 1991 Feb;71(1):147–157. [PubMed]
  • Berlin RB, Jr, Javna SL. Closed suction wide area drainage. Surg Gynecol Obstet. 1992 May;174(5):422–423. [PubMed]
  • Stylianos S, Martin EC, Starker PM, Laffey KJ, Bixon R, Forde KA. Percutaneous drainage of intra-abdominal abscesses following abdominal trauma. J Trauma. 1989 May;29(5):584–588. [PubMed]
  • Dearlove JL. Skin care management of gastrointestinal fistulas. Surg Clin North Am. 1996 Oct;76(5):1095–1109. [PubMed]
  • Irrgang S, Bryant R. Management of the enterocutaneous fistula (continuous education credit). J Enterostomal Ther. 1984 Nov-Dec;11(6):211–228. [PubMed]
  • Adotey JM. External intestinal fistulae in Port Harcourt. West Afr J Med. 1995 Apr-Jun;14(2):97–100. [PubMed]
  • Dutta T, Kulshrestha R. Faecal fistulae in children. Prog Pediatr Surg. 1982;15:195–202. [PubMed]
  • Baigrie RJ, Devitt PG, Watkin DS. Enteral versus parenteral nutrition after oesophagogastric surgery: a prospective randomized comparison. Aust N Z J Surg. 1996 Oct;66(10):668–670. [PubMed]
  • Campos AC, Meguid MM, Coelho JC. Factors influencing outcome in patients with gastrointestinal fistula. Surg Clin North Am. 1996 Oct;76(5):1191–1198. [PubMed]
  • Soeters PB. Gastro-intestinal fistulas: the role of nutritional support. Acta Chir Belg. 1985 May-Jun;85(3):155–162. [PubMed]
  • Meguid MM, Campos AC. Nutritional management of patients with gastrointestinal fistulas. Surg Clin North Am. 1996 Oct;76(5):1035–1080. [PubMed]
  • Waitzberg DL, Plopper C, Terra RM. Postoperative total parenteral nutrition. World J Surg. 1999 Jun;23(6):560–564. [PubMed]
  • Lévy E, Frileux P, Cugnenc PH, Honiger J, Ollivier JM, Parc R. High-output external fistulae of the small bowel: management with continuous enteral nutrition. Br J Surg. 1989 Jul;76(7):676–679. [PubMed]
  • Traverso LW, Abou-Zamzam AM, Maxwell DS, Lacy SM, Tompkins RK. The effect of total parenteral nutrition or elemental diet on pancreatic proteolytic activity and ultrastructure. JPEN J Parenter Enteral Nutr. 1981 Nov-Dec;5(6):496–500. [PubMed]
  • di Costanzo J, Cano N, Martin J, Richieri JP, Mercier R, Lafille C, Lepeuch D. Treatment of external gastrointestinal fistulas by a combination of total parenteral nutrition and somatostatin. JPEN J Parenter Enteral Nutr. 1987 Sep-Oct;11(5):465–470. [PubMed]
  • Rombeau JL, Rolandelli RH. Enteral and parenteral nutrition in patients with enteric fistulas and short bowel syndrome. Surg Clin North Am. 1987 Jun;67(3):551–571. [PubMed]
  • Alexander JW. Bacterial translocation during enteral and parenteral nutrition. Proc Nutr Soc. 1998 Aug;57(3):389–393. [PubMed]
  • Bivins BA, Bell RM, Rapp RP, Toedebusch WH. Pancreatic exocrine response to parenteral nutrition. JPEN J Parenter Enteral Nutr. 1984 Jan-Feb;8(1):34–36. [PubMed]
  • Rolandelli R, Roslyn JJ. Surgical management and treatment of sepsis associated with gastrointestinal fistulas. Surg Clin North Am. 1996 Oct;76(5):1111–1122. [PubMed]
  • Fazio VW, Coutsoftides T, Steiger E. Factors influencing the outcome of treatment of small bowel cutaneous fistula. World J Surg. 1983 Jul;7(4):481–488. [PubMed]
  • Yeo CJ. Management of complications following pancreaticoduodenectomy. Surg Clin North Am. 1995 Oct;75(5):913–924. [PubMed]
  • Ysebaert D, Van Hee R, Hubens G, Vaneerdeweg W, Eyskens E. Management of digestive fistulas. Scand J Gastroenterol Suppl. 1994;207:42–44. [PubMed]
  • Klempa I, Schwedes U, Usadel KH. Verhütung von postoperativen pankreatitischen Komplikationen nach Duodenopankreatektomie durch Somatostatin. Chirurg. 1979 Jul;50(7):427–431. [PubMed]
  • Reichlin S. Somatostatin. N Engl J Med. 1983 Dec 15;309(24):1495–1501. [PubMed]
  • Beglinger C, Drewe J. Somatostatin and octreotide: physiological background and pharmacological application. Digestion. 1999;60 (Suppl 2):2–8. [PubMed]
  • Kutz K, Nüesch E, Rosenthaler J. Pharmacokinetics of SMS 201-995 in healthy subjects. Scand J Gastroenterol Suppl. 1986;119:65–72. [PubMed]
  • Torres AJ, Landa JI, Moreno-Azcoita M, Argüello JM, Silecchia G, Castro J, Hernandez-Merlo F, Jover JM, Moreno-Gonzales E, Balibrea JL. Somatostatin in the management of gastrointestinal fistulas. A multicenter trial. Arch Surg. 1992 Jan;127(1):97–100. [PubMed]
  • Planas M, Porta I, Anglés R, Baena JA, Serra J, Padró JB. Somatostatina y/o nutrición parenteral total en el tratamiento de las fístulas intestinales. Rev Esp Enferm Dig. 1990 Dec;78(6):345–347. [PubMed]
  • Saari A, Schröder T, Kivilaakso E, Kalima T, Lempinen M. Treatment of pancreatic fistulas with somatostatin and total parenteral nutrition. Scand J Gastroenterol. 1989 Sep;24(7):859–862. [PubMed]
  • Barnes SM, Kontny BG, Prinz RA. Somatostatin analog treatment of pancreatic fistulas. Int J Pancreatol. 1993 Oct;14(2):181–188. [PubMed]
  • Scott NA, Finnegan S, Irving MH. Octreotide and postoperative enterocutaneous fistulae: a controlled prospective study. Acta Gastroenterol Belg. 1993 May-Aug;56(3-4):266–270. [PubMed]
  • Sancho JJ, di Costanzo J, Nubiola P, Larrad A, Beguiristain A, Roqueta F, Franch G, Oliva A, Gubern JM, Sitges-Serra A. Randomized double-blind placebo-controlled trial of early octreotide in patients with postoperative enterocutaneous fistula. Br J Surg. 1995 May;82(5):638–641. [PubMed]
  • Nubiola-Calonge P, Badía JM, Sancho J, Gil MJ, Segura M, Sitges-Serra A. Blind evaluation of the effect of octreotide (SMS 201-995), a somatostatin analogue, on small-bowel fistula output. Lancet. 1987 Sep 19;2(8560):672–674. [PubMed]
  • Hernández-Aranda JC, Gallo-Chico B, Flores-Ramírez LA, Avalos-Huante R, Magos-Vázquez FJ, Ramírez-Barba EJ. Tratamiento de las fístulas enterocutáneas con o sin octreótida y nutrición parenteral. Nutr Hosp. 1996 Jul-Aug;11(4):226–229. [PubMed]
  • Hamilton RF, Davis WC, Stephenson DV, Magee DF. Effects of parenteral hyperalimentation on upper gastrointestinal tract secretions. Arch Surg. 1971 Apr;102(4):348–352. [PubMed]
  • Saito Y, Tokutake K, Matsuno S, Noto N, Honda T, Sato T. Effects of hypertonic glucose and amino acid infusions on pancreatic exocrine function. Tohoku J Exp Med. 1978 Feb;124(2):99–115. [PubMed]
  • Boden G, Sivitz MC, Owen OE, Essa-Koumar N, Landor JH. Somatostatin suppresses secretin and pancreatic exocrine secretion. Science. 1975 Oct 10;190(4210):163–165. [PubMed]
  • Ihse I, Larsson J, Lindström E. Surgical management of pure pancreatic fistulas. Hepatogastroenterology. 1994 Jun;41(3):271–275. [PubMed]
  • Dárdai E, Pirityi S, Nagy L. Parenteral and enteral nutrition and the enterocutaneous fistula treatment. II. Factors influencing the outcome of treatment. Acta Chir Hung. 1991;32(4):305–318. [PubMed]
  • Dorta G. Role of octreotide and somatostatin in the treatment of intestinal fistulae. Digestion. 1999;60 (Suppl 2):53–56. [PubMed]
  • Ridgeway MG, Stabile BE. Surgical management and treatment of pancreatic fistulas. Surg Clin North Am. 1996 Oct;76(5):1159–1173. [PubMed]
  • Rolandelli R, Roslyn JJ. Surgical management and treatment of sepsis associated with gastrointestinal fistulas. Surg Clin North Am. 1996 Oct;76(5):1111–1122. [PubMed]
  • Parekh D, Segal I. Pancreatic ascites and effusion. Risk factors for failure of conservative therapy and the role of octreotide. Arch Surg. 1992 Jun;127(6):707–712. [PubMed]
  • Berry SM, Fischer JE. Enterocutaneous fistulas. Curr Probl Surg. 1994 Jun;31(6):469–566. [PubMed]
  • Li SC, Burton FR, Burton MS, Hallett J. The endoscopic diagnosis of iliac colonic fistula and review of literature. Am J Gastroenterol. 1993 Feb;88(2):307–310. [PubMed]
  • Chung MA, Wanebo HJ. Surgical management and treatment of gastric and duodenal fistulas. Surg Clin North Am. 1996 Oct;76(5):1137–1146. [PubMed]
  • Rose DM, Rose AT, Chapman WC, Wright JK, Lopez RR, Pinson CW. Management of bronchobiliary fistula as a late complication of hepatic resection. Am Surg. 1998 Sep;64(9):873–876. [PubMed]
  • Bade PG, Thomson SR, Hirshberg A, Robbs JV. Surgical options in traumatic injury to the extrahepatic biliary tract. Br J Surg. 1989 Mar;76(3):256–258. [PubMed]
  • Güitrón A, Adalid R, Nares J, Albores A. Manejo endoscópico de la fístula biliar. Rev Gastroenterol Mex. 1997 Jan-Mar;62(1):29–33. [PubMed]
  • Davids PH, Rauws EA, Tytgat GN, Huibregtse K. Postoperative bile leakage: endoscopic management. Gut. 1992 Aug;33(8):1118–1122. [PMC free article] [PubMed]
  • Alvarez C, McFadden DW, Reber HA. Complicated enterocutaneous fistulas: failure of octreotide to improve healing. World J Surg. 2000 May;24(5):533–538. [PubMed]
  • Yeo CJ, Cameron JL, Lillemoe KD, Sauter PK, Coleman J, Sohn TA, Campbell KA, Choti MA. Does prophylactic octreotide decrease the rates of pancreatic fistula and other complications after pancreaticoduodenectomy? Results of a prospective randomized placebo-controlled trial. Ann Surg. 2000 Sep;232(3):419–429. [PMC free article] [PubMed]

Figures and Tables

An external file that holds a picture, illustration, etc.
Object name is 00691.f1.jpg
Figure 1 Conceptual algorithm for treatment with somatostatin-14. GI, gastrointestinal.
An external file that holds a picture, illustration, etc.
Object name is 00691.f2.jpg
Figure 2 Somatostatin-14 plus nutritional support (total parenteral nutrition (TPN), enteral nutrition (EN)) may considerably reduce treatment costs.

Articles from Gut are provided here courtesy of BMJ Group


Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...


  • MedGen
    Related information in MedGen
  • PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...