[Management of chylous leakage after radical operation of gastric cancer].

OBJECTIVE

To investigate the management of chylous leakage after radical operation of gastric carcinoma.

METHODS

161 patients with gastric carcinoma underwent D2-D4 dissection. A double catheterization cannula was employed in each patient around the abdominal aorta above the celiac trunk and crus of diaphragm. Postoperatively, the chylous fluid from the drainage tube was observed, smeared and cultured; infection of chylous fluid was treated. The development of chylous leakage was observed and the optimal time to remove the drainage tube was determined.

RESULTS

Chylous leakage occurred in 19 patients. The volume of chylous leakage was less than 250 ml/24 h in 8 patients, 250 - 500 ml/24 h in 7, and 500 - 1500 ml/24 h in 4. Candida albicans was founded in the fluid of chylous leakage in 8 patients, and bacterial infection was found simultaneously in 5 of them. The patients with chylous leakage were healed within 10 - 90 postoperative days. The drainage tube was removed when there was no fluid in the tube and no hydrops in peritoneal cavity by B ultrasound, and the patient were in good condition without signs and symptoms of infections.

CONCLUSION

Chylous leakage after D2 - D4 dissection for gastric carcinoma can be cured by immediate diagnosis, thorough drainage, and anti-infectious treatment with regional and continuative washout when the chylous fluid is infected by Candida or bacteria.