J Korean Surg Soc.  2010 Mar;78(3):165-170. 10.4174/jkss.2010.78.3.165.

Management of Anastomotic Leakage after Gastrointestinal Surgery Using Fluoroscopy-guided Foley Catheter

• Hur H
• Lim YS
• Jeon HM
• Kim W

• KMID: 2211944
• DOI: http://doi.org/10.4174/jkss.2010.78.3.165

Abstract

PURPOSE
The aim of this study is to present cases of postoperative leakage after various types of gastrointestinal operations that were successfully managed with fluoroscopy-guided Foley catheter.
METHODS
Fluoroscopy-guided Foley catheter insertion and drainage methods were performed in 13 leakage sites of 10 patients diagnosed as having leakage after gastrointestinal operations such as esophagectomy, gastrectomy and appendectomy. Under fluoroscopic guidance, a guide-wire was inserted into the leakage site where a Foley catheter was then introduced over the guide wire, inserted and ballooned.
RESULTS
The median time for the procedures was 30 minutes (range: 20~260 minutes), with esophagus or stomach leakage sites requiring a longer procedure time than the appendiceal or duodenal stump. The indwelling Foley catheters were successfully removed after a median of 11 days (range: 8~44 days), and the opening of the enterocutaneous fistulas were spontaneously closed in eight out of 10 patients.
CONCLUSION
The application of this method showed good results and could be a useful method to manage leakage after gastrointestinal surgery, especially in patients with leakage from the stump of the duodenum or appendix.

Keyword

Gastrointestinal surgery; Surgical anastomosis; Complication; Leakage; Foley balloon catheterization

MeSH Terms

Anastomosis, Surgical
Anastomotic Leak
Appendectomy
Appendix
Catheters
Drainage
Duodenum
Esophagectomy
Esophagus
Gastrectomy
Humans
Intestinal Fistula
Stomach

Figure

• 

  Fig. 1 Fluoroscopic findings and illustration of Foley catheter insertion into the site of leakage. (A) Leakage confirmation. (B) The introduction of guide wire through the guide catheter. (C) The insertion and ballooning of the Foley catheter through the guide wire. (D) The confirmation of placement of the Foley catheter by tubogram.

• 

  Fig. 2 Inserted Foley catheter into leaking site and drainage of leaked content in a patient with leakage in the duodenal stump after distal gastrectomy.

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