Clinical Experiences with Chylous Ascites after Gastrectomy for Gastric Cancer

Purpose: Chylous ascites is an accumulation of lymphatic fluid within the peritoneal cavity caused by obstruction or rupture of the peritoneal or retroperitoneal lymphatic drainage system. Postoperative chylous ascites is a rare complication of abdominal surgery. In the present study, we analyzed patients who developed postoperative chylous ascites after gastrectomy. Methods: From February 2003 to June 2006, we treated 7 cases of chylous ascites that occurred after gastrectomy for gastric cancer. We reviewed the medical charts of these patients retrospectively. Results: The incidence of chylous ascites after gastrectomy was 1.7%. Mean triglyceride concentration of the ascitic fluid was 437 ㎎/㎗ (range: 128 ㎎/㎗∼816 ㎎/㎗). Total parenteral nutrition and somatostatin were administered to 6 patients, and 1 patient was treated with oral diuretics and serial paracentesis. Conclusion: The incidence of chylous ascites is low, but may increase with more aggressive surgery. Surgeons should consider chylous ascites if the character of drainage is milky. Conservative management is usually effective for the treatment of postoperative chylous ascites. If conservative management fails, surgical management should be considered.