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

Abstract Background Chylous leakage is a relevant clinical problem after major abdominal surgery leading to an increased length of stay. Data sources A systematic search of MEDLINE/PubMed and the Cochrane Library was performed according to the PRISMA statement. The search for the MeSH terms “chylous...

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Bibliographic Details
Published in:The American journal of surgery 2016-01, Vol.211 (1), p.206-213
Main Authors: Weniger, Maximilian, M.D, D'Haese, Jan G., M.D, Angele, Martin K., M.D, Kleespies, Axel, M.D, Werner, Jens, M.D, Hartwig, Werner, M.D
Format: Article
Language:English
Subjects:
Abdomen
Abdomen - surgery
Abdominal surgery
Biopsy
Blood
Chemotherapy
Chylous Ascites - etiology
Chylous Ascites - therapy
Dissection
Fistula - etiology
Fistula - therapy
Humans
Laboratories
Lymph fistula
Lymphatic Diseases - etiology
Lymphatic Diseases - therapy
Lymphatic system
Medium chain triglyceride diet
Nutrition
Octreotide
Ostomy
Otolaryngology
Pancreatectomy
Pancreatic surgery
Parenteral nutrition
Parenteral Nutrition, Total
Pediatrics
Postoperative Complications - therapy
Risk factors
Rodents
Surgery
Thoracic surgery
Total parenteral nutrition
Treatment Outcome
Tumors
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Summary:Abstract Background Chylous leakage is a relevant clinical problem after major abdominal surgery leading to an increased length of stay. Data sources A systematic search of MEDLINE/PubMed and the Cochrane Library was performed according to the PRISMA statement. The search for the MeSH terms “chylous ascites” and/or “lymphatic fistula” retrieved a total of 2,348 articles, of which 36 full-text articles were reviewed by 2 independent investigators. Results Chylous ascites is described with an incidence of up to 11%, especially after pancreatic surgery. The incidence is increasing with the number of lymph nodes harvested. In patients treated with total parenteral nutrition, conservative treatment is demonstrated to be effective in up to 100% of cases. Conclusions The extent of abdominal surgery mainly predicts the risk of chylous ascites. Conservative treatment has been shown to be effective in almost all cases and is the treatment of choice.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2015.04.012