Analysis of cause and therapy of chylous leakage after pancreaticoduodenectomy

Objective To study and analyze the cause and the experience of prevention and treatment of chylous leakage after pancreaticoduodenectomy(PD). Methods Retrospective study was done in 381 patients underwent pancreaticoduodenectomy in our department from Jan. 2010 to Dec. 2012(including the pyloruspreserving pancreaticoduodenectomy), 23 cases were diagnosed as chylous leakage, accounting for 6.04% of the total. Results In 23 patients with chylous leakage, 21 cases of postoperative pathology were reported malignant tumor of the pancreas, and 2 cases of benign tumors of the pancreas. The average time of chylous leakage was 6 d(5~8 d) after surgery, the daily flux was 260~450 mL(average 355 mL), all patients were cured by conservative treatment. Conclusion Chylous leakage after pancreaticoduodenectomy often occurs in cancer radical resection, in the operation process, the physical effects of lymphatic vessels ligation and uncinate process of membrane are better than the application of ultrasonic scalpel and Ligasure electric surgical techniques. Treatment of chylous leakage after surgery should be based on conservative treatment, the volume of drainage should be closely observated of patients and the treatment strategy should be timely adjusted.