An innovative approach: Withdrawing the drain sudden allows fistula closure in some prolonged postoperative fistulas

Abstract

Abstract Background: Different attitudes are followed in the literature regarding the treatment of postoperative fistulas. We have concluded that the drain can be safely removed in appropriate patients after the fistula tract has matured. Methods: In patients with fistula, drain flow was monitored until the fistula tract developed. In general, we waited until the fifteenth day for safety to ensure that the fistula tract matured. The drain was removed unchanged and unshortened all at once. The patients were followed up with clinical and imaging methods in the next days, weeks, and months. Results: We had a total of 15 patients with fistula. The mean age of the patients was 44.6 (10-81) years. 9 of the 15 patients were male and 6 were female (60%, 40%). Eleven patients developed pancreaticobiliary fistulas, one had a tracheoesophageal fistula, and three had chylous fistulas. Conclusions: In the 15 patients we presented, drains were a mechanical obstacle to the closure of fistulas. After the drain removed patients stasis,leakage or spread did not occur. We think that our experience based on a limited number of patients will bring our thesis that the drain itself prevents fistula closure in some patients to the literature.