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Its Use in the Palliative Treatment of Malignant Duodenocolic and Gastrocolic Fistulas

Michael L. Steer, MD; Donald J. Glotzer, MD

Arch Surg. 1980;115(1):87-89.

Abstract
• Two patients with malignant upper gastrointestinal-to-colon fistulas had palliative operations utilizing the exclusion bypass principle. This principle entails isolating the affected portions of the colon from the remaining large intestine and anastomosing it to itself. Exclusion bypass reduces bacterial contamination of the upper tract (which is the important mechanism for the unrelenting diarrhea and malnutrition), eliminates prograde shunting, which can contribute to symptoms in malignant fistulas, and avoids the potential for closed-loop obstruction.

(Arch Surg 115:87-89, 1980)

Author Affiliations
From the Departments of Surgery, Beth Israel Hospital and Harvard Medical School, Boston.

Footnotes
Accepted for publication June 29, 1979.

Reprint requests to 330 Brookline Ave, Boston, MA 02215 (Dr Glotzer).

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