Leibovitch Ilan
Department of Urology, Sapir Medical Center, Meir Hospital Kfar Saba and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Drugs Today (Barc). 2002 Oct;38(10):687-97. doi: 10.1358/dot.2002.38.10.820141.
Postoperative chylous ascites is a rare complication of retroperitoneal surgery caused by incidental disruption of major retroperitoneal lymphatics and is associated with serious mechanical, nutritional and immunological consequences due to the constant loss of protein and lymphocytes. Different management schemes may be used successfully to treat chylous ascites. Treatment should be adjusted to the severity of the lymphatic leak and its consequences. The management algorithm presented in this article is based on a step-up approach aimed at reducing lymph flow and maintaining nutritional balance. It integrates repeated palliative paracenteses, dietary interventions, total parenteral nutrition therapy, somatostatin therapy, surgical closure of the lymphatic fistula and peritoneovenous shunting. The prognosis of chylous ascites is generally good, with the majority of the cases responding to conservative measures.
术后乳糜性腹水是腹膜后手术罕见的并发症,由腹膜后主要淋巴管意外中断引起,由于蛋白质和淋巴细胞持续丢失,会导致严重的机械、营养和免疫后果。不同的治疗方案可成功用于治疗乳糜性腹水。治疗应根据淋巴漏的严重程度及其后果进行调整。本文提出的治疗算法基于逐步升级的方法,旨在减少淋巴液流动并维持营养平衡。它整合了反复的姑息性腹腔穿刺放液、饮食干预、全胃肠外营养治疗、生长抑素治疗、淋巴管瘘的手术闭合和腹腔静脉分流术。乳糜性腹水的预后通常良好,大多数病例对保守治疗有反应。