Enteral Versus Parenteral Nutrition in the Conservative Treatment of Upper Gastrointestinal Fistula After Surgery

Inclusion Criteria

• •Patients ≥ 18 years
• •Patients having received upper GI surgery for benign or malignant disease including, oesophageal, gastric, duodenal or pancreatic surgery or bariatric surgery
• •Diagnosis of an active postoperative fistula or persisting after a failure of surgical or endoscopic procedure dedicated to close the fistula
• •AL diagnosed from less than 72h AND confirmed on at least two criteria among the followings:
• •clinical symptoms of AL
• •ct scan / ultrason imaging and /or endoscopic diagnosis of AL
• •biologic/bacteriology diagnosis on fluid output
• •intraoperative diagnosis of AL at time of reoperation
• •Indication of nil per mouth
• •American society of anesthesiologist score 1, 2 or 3
• •In case of neoplasm, absence of peritoneal carcinomatosis or distant metastasis
• •No severe concomitant uncontrolled disease
• •Life expectancy more than 6 months
• •No history of allergy or study product intolerance
• •Ongoing healthcare insurance