Fistuloclysis Improves Liver Function and Nutritional Status in Patients with High-Output Upper Enteric Fistula

Abstract

Background.We aimed to determine the efficacy of fistuloclysis in patients with high-output upper enteric fistula (EF).Methods.Patients were assigned into the fistuloclysis group (n=35, receiving fistuloclysis plus total enteral nutrition (TEN)) and the control group (n=60, receiving TEN). Laboratory variables were measured during the four-week treatment.Results.At baseline, variables were similar between the two groups. Delta value was defined as the changes from baseline to day 28. Compared with the control group, the fistuloclysis group showed greater improvements in liver function (Delta total bilirubin (TB):20.3±9.7in the fistuloclysis group versus15.6±6.3in the control group,P=0.040; Delta direct bilirubin (DB):12.5±3.4versus10.0±3.6,P=0.011; Delta alkaline phosphatase (ALP):98.4±33.5versus57.6±20.9,P<0.001); nutritional status (Delta total protein:21.8±8.7versus10.7±2.1,P<0.001; Delta albumin:11.3±2.5versus4.2±1.3,P<0.001). In the fistuloclysis subgroups, biliary fistula patients had the maximum number of variables with the greatest improvements.Conclusions.Fistuloclysis improved hepatic and nutritional parameters in patients with high-output upper EF, particularly in biliary fistula patients.