Postoperative chyle leak after pancreatic surgery – Is treatment effective? - 20/05/21
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Highlights |
• | Chyle leak prolongs length of stay. |
• | Prediction of chyle leak was not possible using parameters of the performed surgery. |
• | Dietary treatment did not reduce morbidity or time to drain removal. |
• | Patients un- or under-treated for CL did not experience CL-associated morbidity within 3 months postoperatively. |
Summary |
Purpose |
With increasing soft tissue clearance in pancreatic cancer surgery, postoperative chyle leak (CL) has become a more commonly observed complication. Recently, a new consensus definition was established by the International study group of pancreatic surgery (ISGPS). The aim of the present analysis was to evaluate risk factors and treatment options of patients with CL after pancreatic surgery.
Methods |
Two hundred and twenty-eight patients with serous or chylous drainage after pancreatic surgery were included in this analysis of a prospectively collected database between 01/2014 and 12/2016. Risk factors for CL and treatment options were compared. A subgroup analysis on those patients, who had drain removal despite of persistent CL with respect to the need of subsequent percutaneous drainage or reoperation within three months postoperatively, was performed.
Results |
Sixty patients with CL were identified. Of those, 41 patients were treated with medium-chain triglyceride-diet, with a median duration of therapy of 12 days. In patients with CL, the type of treatment had no effect on time to drain removal (P=0.29) and morbidity (P=0.15). Furthermore, morbidity was not increased in patients who had their drains removed despite persistent CL (P=0.84). None of the latter patients had percutaneous drainage or reoperation for CL after removal of the surgical drains.
Conclusions |
Dietary treatment may not be very effective in treating CL. Further research is warranted to explore the effect and necessity of CL treatment.
El texto completo de este artículo está disponible en PDF.Keywords : Chylous ascites, Total parenteral nutrition, MCT-diet
Esquema
| ☆ | Previous presentations at meetings and conferences: Data from this study were presented at the European pancreatic club in Budapest 2017 (abstract published in Pancreatology, j.pan.2017.05.216), German pancreatic club in Greifswald 2017, at the annual meeting of the Association of Bavarian surgeons 2017 and the annual meeting for Visceral medicine in Dresden 2017. |
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