Kim Beom Soo, Seo Youngbin, Kang Chang Moo
Yonsei University College of Medicine, Seoul, Korea.
Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
Korean J Clin Oncol. 2022 Dec;18(2):78-82. doi: 10.14216/kjco.22010. Epub 2022 Dec 30.
A patient showed signs of fever and Hemovac insertion site discharge 8 days after surgery and was admitted. Abdominal paracentesis found milky ascites with triglyceride levels of the peritoneal fluid as high as 1,603 g/mL. Diagnosed as chylous ascites, symptomatic therapy such as empirical antibodies and diuretics was administered with paracentesis before being discharged. The ascites volume increased again, and the patient was re-admitted. The patient was treated with orlistat, octreotide, total parenteral nutrition administration, ascites drainage, and diuretics. Ascites levels increased further and intraperitoneal Viscum was administered. Clear ascites was observed, and the patient was discharged. We reported a case where conventional treatment for chylous ascites that occurred after pancreaticoduodenectomy was shown to be ineffective while Viscum extracted from mistletoe was able to manage chylous ascites.
一名患者术后8天出现发热及Hemovac引流管置入部位渗液，随后入院。腹腔穿刺发现乳糜性腹水，腹水甘油三酯水平高达1603g/mL。诊断为乳糜性腹水，在出院前行腹腔穿刺并给予经验性抗感染及利尿剂等对症治疗。腹水再次增多，患者再次入院。给予患者奥利司他、奥曲肽、全胃肠外营养支持、腹水引流及利尿剂治疗。腹水水平进一步升高，遂行腹腔内注射槲寄生提取物。观察到腹水变清，患者出院。我们报告了1例胰十二指肠切除术后发生的乳糜性腹水，常规治疗无效，而槲寄生提取物能够治疗乳糜性腹水的病例。
