Treatment options for chylous ascites after major abdominal surgery: a systematic review

Weniger, Maximilian; D’Haese, Jan G.; Angele, Martin K.; Kleespies, Axel; Werner, Jens; Hartwig, Werner

doi:10.1016/j.amjsurg.2015.04.012

Cited by 133 publications

(150 citation statements)

References 47 publications

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“…It consists of low lipid and high medium-chain triglycerides diet. In case of failing, total parenteral nutrition and somatostatin analogs may be used (46). Surgery should be reserved for cases that do not respond to conservative treatment.…”

Section: Chylous Fistulamentioning

confidence: 99%

Management of postoperative complications of lymphadenectomy

Barchi¹,

Charruf²,

Oliveira³

et al. 2016

Transl. Gastroenterol. Hepatol.

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Gastric cancer remains a disease with poor prognosis, mainly due to its late diagnosis. Surgery remains as the only treatment with curative intent, where the goal is radical resection with free-margin gastrectomy and extended lymphadenectomy. Over the last two decades there has been an improvement on postoperative outcomes. However, complications rate is still not negligible even in high volume specialized centers and are directly related mainly to the type of gastric resection: total or subtotal, combined with adjacent organs resection and the extension of lymphadenectomy (D1, D2 and D3). The aim of this study is to analyze the complications specific-related to lymphadenectomy in gastric cancer surgery.

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Section: Chylous Fistulamentioning

confidence: 99%

Management of postoperative complications of lymphadenectomy

Barchi¹,

Charruf²,

Oliveira³

et al. 2016

Transl. Gastroenterol. Hepatol.

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“…Direct surgical trauma of the CC and its main afferent ducts is of growing importance following abdominal surgery because of the increase in laparoscopic abdominal procedures (Weniger et al. ). CC injuries have been reported after anterior spinal procedures (Akcali et al.…”

Section: Discussionmentioning

confidence: 99%

“…) as well as pelvic, colorectal, hepatic, pancreatic and gastric surgery with incidence rates varying from 1 to 11% (Weniger et al. ). CC injuries may cause chylous leakage, resulting in chylous ascites, usually leading to significant morbidity from malnutrition, immunosuppression and septic complications (Akcali et al.…”

Section: Discussionmentioning

confidence: 99%

A radio‐anatomical correlation study of the cisterna chyli

et al. 2018

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Surgical laparoscopic procedures in the retroperitoneal and supramesocolic spaces are increasingly frequent. There is a high risk of iatrogenic intraoperative injury of the retroperitoneal lymphatic structures during these procedures. A precise understanding of the anatomy of the thoracic duct (TD) and the cisterna chyli (CC) is essential for safe surgical procedures in this area. However, routine imaging procedures rarely and often incorrectly visualize the CC. The objective of this study was to evaluate the feasibility of a retrograde injection of the TD to fill the CC with a contrast agent in 16 human cadavers. Both magnetic resonance lymphography (MRI) and computed tomography (CT) studies could be performed on the same anatomical specimen, using a contrast medium which hardened, allowing gross dissection. MRI and CT detectability were evaluated, and imaging results were compared with the anatomical dissection. The CC of 12/16 cadavers were successfully injected, and four were unsuccessful due to technical difficulties, showing the effectiveness of the method. This technique can improve understanding of the anatomy of the TD and CC and provides an original option to study the complex anatomy of these structures by correlating precise cadaveric dissections with cross-sectional imaging.

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“…Postoperative chylous ascites (PCA) is a very rare complication caused by unobserved interruption of the major retroperitoneal lymphatic channels and by formation of lymphoperitoneal fistula following retroperitoneal and mediastinal surgery (1). Although PCA is rarely observed, the need to diagnose and treat the condition as a clinical state has been increasing in importance with the increased number of wide resections and lymph node dissections being performed during abdominal surgery (2). Increased attention to PCA is warranted to due to its consequences, namely prolonged duration of hospitalization and increased medical costs arising from the need to treat the malnutrition, dehydration, immunosuppression, and/or septic complications associated with the condition (2).…”

Section: Introductionmentioning

confidence: 99%

“…Although PCA is rarely observed, the need to diagnose and treat the condition as a clinical state has been increasing in importance with the increased number of wide resections and lymph node dissections being performed during abdominal surgery (2). Increased attention to PCA is warranted to due to its consequences, namely prolonged duration of hospitalization and increased medical costs arising from the need to treat the malnutrition, dehydration, immunosuppression, and/or septic complications associated with the condition (2). Despite the importance of increasing knowledge of PCA, very few case studies have described the nature of PCA complications that develop after adrenalectomy and their successful treatment (3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

Chylous ascites after resection of giant adrenocortical carcinoma

Habibi¹,

Karakoyun

Demirci

et al. 2016

Gland Surg.

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Postoperative chylous ascites (PCA) is a rare clinical state that occurs during abdominal surgery.Despite its rarity, the need to diagnose and treat PCA is increasing in importance with the increased number of wide resections and lymph node dissections being performed and the serious consequences of treatment. Here we describe the PCA complications we observed after resection for treating a case of giant adrenocortical carcinoma and we have the brief review of the PCA complication.

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Treatment options for chylous ascites after major abdominal surgery: a systematic review

Cited by 133 publications

References 47 publications

Management of postoperative complications of lymphadenectomy

Management of postoperative complications of lymphadenectomy

A radio‐anatomical correlation study of the cisterna chyli

Chylous ascites after resection of giant adrenocortical carcinoma

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