Management of chylous ascites following pancreaticobiliary surgery

BACKGROUND: Chyle leak is an uncommon form of ascites occurring due to the accumulation of lipid-rich lymph into the peritoneal cavity. Traumatic injury to the lymphatic system due to pancreaticobiliary surgery can lead to this phenomenon. METHOD: We retrospectively evaluated the data of 159 patients of pancreticobiliary surgery from January 2012 to December 2016. Five patients (5/137, 3.6%) sustained a chylous leak following pancreaticoduodenectomy and one patient (1/22, 4.5%) sustained a chylous leak following Roux-en-Y hepaticojejunostomy for postcholecystectomy biliary stricture. RESULTS: : 10-40 days). All the patients were successfully managed conservatively with a combination of customized enteral feeds, supplemental parenteral nutrition, and octreotide. One patient required additional percutaneous drainage. CONCLUSION: Chyle leak can be successfully treated with conservative management but at the cost of increased hospital stay.