Clinical Analysis of Chylous Ascites after Surgery for Gastric Cancer

위암수술 후 발생한 유미성 복수증의 임상적 고찰

  • Hong Jeong Hun (Department of Surgery, Korea University College of Medicine) ;
  • Min Byung Wook (Department of Surgery, Korea University College of Medicine) ;
  • Lee Gyung Bum (Department of Surgery, Korea University College of Medicine) ;
  • Mok Young Jae (Department of Surgery, Korea University College of Medicine)
  • 홍정훈 (고려대학교 의과대학 외과학교실) ;
  • 민병욱 (고려대학교 의과대학 외과학교실) ;
  • 이경범 (고려대학교 의과대학 외과학교실) ;
  • 목영재 (고려대학교 의과대학 외과학교실)
  • Published : 2002.03.01

Abstract

Purpose: Chylous ascites is an accumulation of lymphatic fluid within the peritoneal cavity due to trauma or to an obstruction on the lymphatic system. Postoperative chylous ascites is a rare complication of abdominal surgery. It is frequently reported after retroperitoneal dissections and results in high morbidity and mortality. However, there have been few report of such a complication following a radical gastrectomy. Therefore, we review the clinical analysis and treatment of chylous ascites based on our experience. Materials and Methods: From July 1992 to June 2001, we treated 13 cases of chylous ascites after operations for gastric cancer. We reviewed medical charts of those patients retrospectively. Results: The incidence of chylous ascites after operations for gastric cancer was $0.83\%$ (13/1552). The mean time from ingestion of a meal after the operation to the development of symptoms was 2 days (range: $1\∼6$ days). Conservative treatment by fasting, total parenteral nutrition (TPN), and repeated paracentesis was successful in all patients. The mean time from diagnosis to complete resolution was 25 days (range: $2\∼105$ days). Conclusion: Chylous ascites should be considered in any patient with a typical milky color of drainage who has recently undergone radical gastrectomy. Treatment with fasting, TPN, and repeated paracentesis usually is successful.