(Objectives) It is recognized that Chylous leakage is a rare complication but is a relevant clinical problem after major abdominal surgery. It was occasionally reported in urologic surgery, but the data about its incidence and treatment outcome is still lacking. In this study, we reviewed our cases of chylous leakage after laparoscopic adrenalectomy or nephrectomy. (Patients and methods) From January 2005 to September 2014, laparoscopic adrenalectomies or nephrectomies were performed in 300 patients. The factors that affected the development of chylous leakage were analyzed. (Results) The overall incidence of chylous leakage was 4.3% (13 of 300 cases). All chylous leakage was seen on the left side, and it was commonly developed in patients with lymph node dissection or excessive hilar dissection around the left renal pedicle. Importantly, all cases were successfully managed conservatively by a low fat diet with or without octreotide. (Conclusions) Our results suggest that chylous leakage is not a rare complication after laparoscopic adrenalectomy or nephrectomy, but most cases can be treated conservatively. Chylous leakage can occur in patients with lymphadenectomy or hilar dissection on the left side.
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Article Synopsis
- The study focused on using ultrasound-guided intranodal lymphangiography to diagnose and treat chylous ascites, a serious complication after abdominal surgery, particularly when conservative treatments failed.* -
- Ten patients with chylous ascites, primarily following liver surgery, participated in the study, and lymphangiography was successfully performed on all, using an average of 4.5 ml of lipiodol.* -
- The results indicated that lymphangiography not only identified leakage sites but also resolved the condition in 6 patients without needing additional surgery, suggesting it might be a viable treatment option.*
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