Chyle leakage and early enteral feeding following pancreatico-duodenectomy: management options.

Abstract:

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.

journal_name

Dig Surg

journal_title

Digestive surgery

authors

Malik HZ,Crozier J,Murray L,Carter R

doi

10.1159/000108324

subject

Has Abstract

pub_date

2007-01-01 00:00:00

pages

418-22

issue

6

eissn

0253-4886

issn

1421-9883

pii

000108324

journal_volume

24

pub_type

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