Chyle leak after laparoscopic cholecystectomy in a patient with necrotizing pancreatitis: reporting a rare case
DOI:
https://doi.org/10.18203/2349-2902.isj20254347Keywords:
Chyle leak, Laparoscopic cholecystectomy, Necrotizing pancreatitis, Conservative managementAbstract
Chyle leak after laparoscopic cholecystectomy is an extremely rare post operative complication, usually related to inadvertent lymphatic injury in patients with distorted anatomy. We report a 70-year-old male with type 2 diabetes mellitus, hypothyroidism, and a recent history of necrotizing pancreatitis, who underwent elective laparoscopic cholecystectomy. Intraoperatively, frozen Calot’s anatomy and dense adhesions were encountered. A postoperative subhepatic drain revealed milky fluid, which was confirmed biochemically as chyle. The patient was successfully managed conservatively with dietary modifications, medium-chain triglyceride supplementation, and octreotide. Although rare, chyle leak should be considered in patients with postoperative milky drain output after laparoscopic cholecystectomy. Conservative management is effective in most cases, but requires early recognition, multidisciplinary input, and close follow-up.
References
Jensen EH, Weiss CA. Management of chylous ascites after laparoscopic cholecystectomy using minimally invasive techniques: A case report and literature review. Am Surg. 2006;72(1):60–3.
Huang YM, Chen JH, Liu SH, Lin MT. Chyle leakage after laparoscopic cholecystectomy for acute biliary pancreatitis: A case report. Hepatogastroenterology. 2009;56(89):39–42.
Gogalniceanu P, Purkayastha S, Spalding D, C Zacharakis E. Chyle leak following laparoscopic cholecystectomy: A rare complication. Ann R Coll Surg Engl. 2010;92(7):12–4.
Bansal A, Bansal AK, Bansal V, Singh Mamta. Spontaneous chylous ascites after laparoscopic cholecystectomy: A case report. Int Surg J. 2016;3(1):408–10.
Ong F, Das A, Rajkomar K. Chyle leak post laparoscopic cholecystectomy: A case report, literature review and management options. Ann Laparosc Endosc Surg. 2021;6:25.
Philip D, Garcia M, Anika M, Avila A, Seaver C. Laparoscopic cholecystectomy: Post-operative bile and chyle leaks. A case report. J Surg Case Rep. 2023;2023(9): rjad532.
Dababneh Y, Mousa OY. Chylous ascites. In: StatPearls. Treasure Island (FL): 2023.
Delaney SW, Shi H, Shokrani A, Sinha UK. waiytManagement of chyle leak after head and neck surgery: Review of current treatment strategies. Int J Otolaryngol. 2017;2017:8362874.
Downloads
Published
How to Cite
Issue
Section
