[Endoscopic experience with the Montgomery salivary bypass tube in esophageal stenosis and fistulae].

Objective: Provide the initial endoscopic experience in the placing of the Montgomery salivary bypass tube (MSBT).

Patients And Methods: Descriptive, retrospective study in 7 patients in the Digestive System Unit of EsSALUD Hospital Edgardo Rebagliati Martins in Lima-Peru from November 2003 to January 2006.

Results: The average age of the patients was 34.68 years (2 years, 8 months - 76 years); 85.1% were male, 71.4% required hospitalization in the Intensive Care Unit. In 5 patients, the MSBT indications were some kind of fistula in the esophagus, and stenosis in 2 patients, one crichopharyngeal and the other gastric transposition with anastomosis in the cervical esophagus. The endoscopic help for the placing of the MSBT was required in 81.8% and for withdrawal in 77.7%. In the six (6) adult patients, sedation, the endoscopic procedure and the placing of the MSBT were well-tolerated. The average time that the MSBT was in place was 70.5 days. In two (2) patients (28.6%), there were complications associated with the MSBT: one had odinophagia which required withdrawal on the seventh day and another patient had anterograde migration of the MSBT with fatal perforation of the small intestine. In 57.1% of the cases, the fistula or stenosis was cured; in 28.6%, there was partial improvement.

Conclusions: The endoscopic technique for the insertion of the MSBT serves as an alternative, allows the diagnosis, confirmation, comparison of fistulas or stenosis in the cervical esophagus and is well-tolerated.