Cause analysis and therapeutic methods of chylous leakage after pancreaticoduodenectomy

OBJECTIVES: To study and analyze the causes of chylous leakage after pancreaticoduodenectomy.

METHODS: We retrospectively analyzed 381 patients who underwent pancreaticoduodenectomy (including pylorus-preserving pancreaticoduodenectomy) in Shanghai Chang Hai Hospital Affiliated to the Second Military Medical University, Shanghai, China between January 2010 and December 2012. We also studied the relationship between postoperative chylous leakage and age, gender, surgical approach, and the tumor nature.

RESULTS: The chylous leak was placed in 23 patients and the incidence of chylous leakage in patients was 0.6%. There was no significant difference in gender, age and tumor pathological pattern between the chylous leakage group and non-chylous leakage group. The incidence of chylous leakage in patients with N1 grade cancer was significantly higher than that in patients with N0 grade cancer (p=0.001). The incidence of chylous leakage in patients suffering R0 resection was significantly higher than that in patients suffering non-R0 resection (p=0.008). All patients were successfully treated conservatively.

CONCLUSION: The incidence of chylous leakage was 0.6% and the chylous leakage was closely linked with the tumor’s grade malignancy and the range of radical resection.