Peri-operative chylous ascites

P. J. Gaglio, C. B. Leevy, B. Koneru

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Chylous ascites occurs when lymphatics are disrupted due to primary lymphatic disease, infection, malignancy, or chronic liver disease. It may also occur following inadvertent interruption of abdominal lymphatics during surgery involving retroperitoneal dissection. It is suggested by some that during liver transplantation, severed hepatic lymphatics should be ligated or stented to avoid post-operative pleural and abdominal accumulation of chylous fluid. The occurrence of chylous ascites and the need to ligate lymphatics after orthotopic transplantation was assessed in 180 consecutive patients subjected to this procedure. Preoperative chylous ascites present in one patient resolved following transplantation. Three patients who required retroperitoneal dissection to complete the biliary anastomosis via choledochojejunostomy or perform a hepatic artery graft developed post- operative chylous ascites which rapidly resolved without complications. These findings indicate special attention to transacted hepatic lymphatics is not required during orthotopic liver transplantation and its transitory development is due to retroperitoneal dissection.

Original languageEnglish (US)
Pages (from-to)369-376
Number of pages8
JournalJournal of Medicine
Volume27
Issue number5-6
Publication statusPublished - Dec 1 1996

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Keywords

  • Choledochocholedochostomy
  • Roux-en-Y choledochojejunostomy
  • chylous ascites
  • liver transplantation
  • lymphangiomatosis
  • lymphectasia
  • lymphocele

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Gaglio, P. J., Leevy, C. B., & Koneru, B. (1996). Peri-operative chylous ascites. Journal of Medicine, 27(5-6), 369-376.