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- Title
Chylous ascites after associating liver partition and portal vein ligation for stage hepatectomy (ALPPS): overview and case report.
- Authors
Gallegos, Luz Estefanía González; Velázquez, Carlos Alberto Córdova; Azuela, Oscar Chapa; Preciado, Irving Hugo Aguilar; Vásquez, Carmen Judith Roca; García, Jorge Alberto Roldan
- 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.
- Subjects
PORTAL vein; HEPATECTOMY; ASCITES; THERAPEUTICS; LIVER cancer
- Publication
Journal of Surgical Case Reports, 2024, Vol 2024, Issue 5, p1
- ISSN
2042-8812
- Publication type
Case Study
- DOI
10.1093/jscr/rjae357