Chylous ascites and persistent hiccups as complications after laparoscopic radical nephrectomy

A patient in his mid-40s with a history of gastric ulcer and gastro-oesophageal reflux disease presented with 6 months of left flank discomfort. He was diagnosed with stage III (cT3aN1M0) papillary renal cell carcinoma and received neoadjuvant therapy for 3 months. Follow-up imaging showed partial response with residual carcinoma and metastatic lymphadenopathies. The patient subsequently underwent laparoscopic radical nephrectomy with lymph node dissection. Postoperatively, he developed chylous ascites and subsequent persistent hiccups as unusual complications. Although chylous ascites improved gradually, the hiccups persisted despite non-pharmacological interventions and pharmacological treatments. Finally, the hiccups ceased following the removal of the J-P drain which ended up stimulating the phrenic nerve by the J-P drain at left renal fossa.