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<p>A&#xa0;postoperative chyle leakage (CL) is caused by intraoperative damage to the main lymphatic vessels or their tributaries. It is characterized by the secretion of a&#xa0;triglyceride-rich fluid, which classically has a&#xa0;characteristic milky appearance in a&#xa0;percutaneous drain. In visceral surgery CLs mostly occur after pancreatic and esophageal surgery but rarely occur after colorectal, liver or gastric surgery. Treatment often consists of a&#xa0;diet rich in medium chain triglycerides (MCT) to reduce the lymphatic flow, while ensuring a&#xa0;sufficient nutrient supply. If the CL does not cease, total parenteral nutrition is usually carried out. A&#xa0;reoperation, lymphography sometimes with percutaneous intervention or short-term irradiation for CL are rarely necessary. A&#xa0;CL frequently results in a&#xa0;prolonged hospital stay and can be accompanied by other complications but is rarely associated with a&#xa0;poorer prognosis.</p>

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Postoperative Lymphfistel nach viszeralchirurgischen Eingriffen – diagnostische und therapeutische Strategien

  • 期刊论文

  • 发表日期：

    2025年5月8日

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  • Alina S. Ritter,
  • Jelte Poppinga,
  • Kira C. Steinkraus,
  • Anna Nießen,
  • Thilo Hackert

摘要

A postoperative chyle leakage (CL) is caused by intraoperative damage to the main lymphatic vessels or their tributaries. It is characterized by the secretion of a triglyceride-rich fluid, which classically has a characteristic milky appearance in a percutaneous drain. In visceral surgery CLs mostly occur after pancreatic and esophageal surgery but rarely occur after colorectal, liver or gastric surgery. Treatment often consists of a diet rich in medium chain triglycerides (MCT) to reduce the lymphatic flow, while ensuring a sufficient nutrient supply. If the CL does not cease, total parenteral nutrition is usually carried out. A reoperation, lymphography sometimes with percutaneous intervention or short-term irradiation for CL are rarely necessary. A CL frequently results in a prolonged hospital stay and can be accompanied by other complications but is rarely associated with a poorer prognosis.