Q: I am a 27 years old woman who had weight loss surgery done 4 months back. After 2 days, one of the staples came off and I had peritonitis. I am tube fed and have an appratus that collects whatever my stomach drains, which is mostly saliva. Even though I am draining less now, the perforation doesn't seem to close even after 4 months. When I left the hospital I was draining 180 ml per day, which came down to 13 ml/day, but now it has increased to 50-60 ml/day again. I am taking Ensure and Isopure and the nutrients in these two are supposed to help the perforation close. Two days back, I had blood work done and everything was fine, except my albumin levels were low. Is it essential that my albumin should be high in order to get the perforation closed?

A:Your doctor can give the best advice. In general, fistula closures can take time. In some cases, I have urged my patients to wait for 6 months, or more, if in my judgment the fistula would close. If the fistula output has fallen the likelihood is high that it will close. It is usually not advisable to become impatient and try to close the fistula by another surgery. However, as I said earlier, you should follow your doctors advice. He can tell whether or not this specific fistula is likely to close.