PDF(Pubmed)
Abstract：
Chylous ascites is an uncommon pathology with low incidence following hepato-pancreato-biliary surgery, there are no cases reported in the international literature following the associating liver partition and portal vein ligation for stage hepatectomy (ALPPS) procedure. It is caused by abnormal intraperitoneal accumulation of lymph fluid in the abdominal cavity secondary to obstruction or injury to the chyle cistern or its tributaries. We describe the case of a 49-year-old woman diagnosed with colon cancer and liver metastasis. ALPPS was performed, on a first and second stage, presenting a high drainage output as well as change in the characteristics of the drainage fluid. The diagnosis of chylous ascites was confirmed by finding triglyceride levels in the drainage fluid at 300 mg/dL. Medical treatment was started based on a hyper-protein diet and fat restriction, supplemented with medium-chain triglycerides and somatostatin analog, with fistula resolution. It can be managed with medical treatment.
摘要：
乳糜腹水是一种罕见的病理，在肝胰胆管手术后发病率低，在联合肝分区和门静脉结扎进行分期肝切除术(ALPPS)后,国际文献中没有报道病例.它是由腹腔内淋巴液的异常积聚引起的，继发于乳糜池或其支流的阻塞或损伤。我们描述了一名49岁女性被诊断患有结肠癌和肝转移的情况。进行了ALPPS,在第一阶段和第二阶段，呈现高排水输出以及排水流体特性的变化。通过发现300mg/dL的引流液中的甘油三酸酯水平来确认乳糜性腹水的诊断。药物治疗是基于高蛋白质饮食和脂肪限制，补充中链甘油三酯和生长抑素类似物，与瘘管分辨率。它可以通过医疗来管理。
