Background: Chyle leaks are a rare complication following abdominal surgery. The aim of this study is to describe the management of chyle leaks following surgery for pancreatico-duodenal malignancy. Methods: Data were collated from a consecutive series of 105 patients who had undergone a pancreatico-duodenectomy for malignancy. From this cohort, patients who developed significant chyle leaks, defined as drainage of more than 600 ml of amylase-poor chylous fluid per day, were identified and their management reviewed. Results: A total of 7 (6.7%) patients with significant chyle leaks were identified. All but one of the chyle leaks were identified between the 5th and 9th post-operative day. Early restoration of enteral feeding appeared to increase the incidence of chyle leak. Six of the 7 patients were successfully treated conservatively with total parenteral nutrition and after a median of 7.5 days the chyle leak had resolved. One patient required a peritoneovenous shunt for chylous ascites. Conclusion: This study has described a high incidence of chyle leak among patients undergoing surgery for pancreatico-duodenal malignancy. Early introduction of enteral feed may encourage development. However, patients who develop an abdominal chyle leak remain clinically well and the leak can be managed relatively easily with parenteral nutrition.

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Objective The impact of encouragement on performance has been observed in the setting of exercise, but further research is necessary in running. To compare the improvement in pace experienced by subjects of different backgrounds (from a running team, non-running sports team, or no sports team) as a result of active (verbal encouragement) and passive social facilitation, this study was conducted. Method Eighteen male high school students, age 17.3±0.75 years were recruited for this study, six from each background listed above. Participants were randomly assigned to one of three treatments: external verbal encouragement (EVE), without external verbal encouragement (WEVE), or no presence. Improvement in pace after the introduction of a social facilitator was recorded along with overall consistency in pace. Statistical significance was set at α = 0.10. Results A significant improvement in short-term pace among subjects from a running team was generated by EVE, t(1) = -5.198, p = 0.0605, and no presence generated a significant improvement in short-term pace among subjects from a non-running sports team, t(1) = -5, p = 0.0669. EVE also generated a significant improvement in long-term pace among subjects from a running team, t(1) = -5.069, p = 0.0620. A conclusion on consistency was not reached. Conclusion Verbal encouragement saw to long-term and short-term improvement in pace of subjects selected from a running team, while the lack of presence assisted the short-term performance of subjects selected from non-running sports teams. Results obtained offer potential to impact competitive long-distance running.

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