Chylous ascites after right liver resection

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Aylhin J. López Marcano
Roberto De la Plaza Llamas
José M. Ramia Ángel
Aníbal A. Medina Velasco
Raquel Latorre Fragua
Alba Manuel Vázquez

Abstract

Postoperative chylous ascites is an intraperitoneal collection of lymphatic fluid enriched with longchain triglycerides that results from injury of the cisterna chyli or its main tributaries. This complication is rare after liver resections. Here, we report on the case of a 44 year-old man with a T3N1 rectal adenocarcinoma 16 cm above the anal margin, with metastatic compromise of almost the entire right liver lobe. Following chemotherapy, he underwent right liver resection. On postoperative day four, the thoracic drain evidenced milky fluid containing triglyceride 223 mg/dL with serum triglycerides 77 mg/ dL. A fat-free diet was indicated with fat-free protein supplements, medium chain triglycerides and octreotide (100 μg subcutaneously every 8 hours), with complete resolution. In conclusion, postoperative chylous complications may be treated successfully by a less aggressive approach, with oral diet, subcutaneous octreotide, fat-free diet supplemented with proteins and medium chain fatty acids.

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How to Cite
López Marcano, A. J., De la Plaza Llamas, R., Ramia Ángel, J. M., Medina Velasco, A. A., Latorre Fragua, R., & Vázquez, A. M. (2021). Chylous ascites after right liver resection. Revista Argentina De Cirugía, 112(1), 58–62. https://doi.org/10.25132/raac.v112.n1.1418.es (Original work published March 22, 2021)
Section
Scientific Letter

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