Rajasekar A, Ravi N R, Diggory R T
Victoria Hospital, Kirkcaldy, Fife, Scotland.
Int J Clin Pract. 2000 Apr;54(3):201-3.
Chylous ascites is the accumulation of lymphatic fluid within the peritoneal cavity, due to trauma or obstruction to the lymphatic system. Postoperative chylous ascites is a rare complication of abdominal surgery. This is frequently reported after retroperitoneal dissections, and results in high morbidity and mortality. The treatment options are varied and include total parenteral nutrition (TPN), elemental diet with medium chain triglycerides (MCT), repeated paracentesis and surgical ligation. We report a case of post-operative chylous ascites after D2 distal gastrectomy. Treatment by fasting, TPN followed by fat-free diet resulted in complete resolution of ascites within 3 weeks. To our knowledge this is the first report of such a complication following radical gastrectomy. We review the literature and briefly discuss the management options.
乳糜性腹水是指由于创伤或淋巴系统阻塞，导致腹腔内淋巴液积聚。术后乳糜性腹水是腹部手术罕见的并发症。这在腹膜后解剖术后经常报道，会导致高发病率和死亡率。治疗选择多种多样，包括全胃肠外营养（TPN）、含中链甘油三酯（MCT）的要素饮食、反复腹腔穿刺放液和手术结扎。我们报告1例D2远端胃切除术后发生乳糜性腹水的病例。通过禁食、TPN随后给予无脂饮食治疗，腹水在3周内完全消退。据我们所知，这是根治性胃切除术后发生这种并发症的首例报告。我们回顾文献并简要讨论治疗选择。
