Division of Transplantation, Department of Surgery, University of Minnesota, Minneapolis, MN, USA.
Am J Transplant. 2010 Jan;10(1):124-8. doi: 10.1111/j.1600-6143.2009.02883.x. Epub 2009 Dec 2.
Chylous ascites as a result of laparoscopic donor nephrectomy (LDN) is a rare complication that carries significant morbidity, including severe protein-calorie malnutrition and an associated immunocompromised state. We report a patient who underwent hand-assisted left LDN and subsequently developed chylous ascites. He failed conservative therapy including low-fat diet with medium-chain triglycerides (LFD/MCT) and oral protein supplementation as well as strict NPO status with intravenous (IV) total parenteral nutrition (TPN) and subcutaneous (SQ) somatostatin analogue administration. Laparoscopic re-exploration and intracorporeal suture ligation and clipping of leaking lymph channels successfully sealed the chyle leak. We review the literature to date including diagnosis, incidence, management options, psychosocial aspects and clinical outcomes of chylous ascites after LDN.
腹腔镜供肾切除术（LDN）导致乳糜性腹水是一种罕见的并发症，可导致严重的蛋白质-热量营养不良和相关的免疫功能低下。我们报告了一位接受左手辅助腹腔镜左 LDN 后发生乳糜性腹水的患者。他在接受低脂饮食加中链甘油三酯（LFD/MCT）和口服蛋白质补充剂的保守治疗以及严格禁食状态下的静脉（IV）全胃肠外营养（TPN）和皮下（SQ）生长抑素类似物给药后，仍未治愈。腹腔镜再次探查和腔内缝合结扎及夹闭漏出的淋巴管成功地封堵了乳糜漏。我们回顾了迄今为止的文献，包括 LDN 后乳糜性腹水的诊断、发病率、治疗选择、社会心理方面和临床结果。
