AIM:To compare the outcomes of conservative vs sur gical treatment of enterocutaneous fistulae (ECF) in a community teaching hospital over a decade.
METHODS:All cases of ECF between 1997 and 2007 were reviewed for management strategy.
RESULTS:Of the 83 patients with ECF, 60 (72%) were postoperative. Sixtysix patients (79.5%) were treated initially with conservative measures. Eighteen patients failed to respond to conservative treatment and required later (secondary) exploration; this group consisted of an equal number of low vs high output fistulae. Seventeen (20.5%) patients underwent initial (primary) definitivesurgery secondary to anastomotic leak and peritonitis. Surgical procedures included resection of ECF with anastomosis (24), exclusion (6) and directdrainage (4). No significant difference was seen in the recurrence rate for conservative (10%) vs operativetreatment (20%).
CONCLUSION:Conservative treatment plays a pivotal role as an initial management in both low and high out put fistulae. In selective cases only, early primary explo ration is recommended.