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Chylous Ascites Requiring Surgical Intervention after Donor Nephrectomy: Case Series and Single Center Experience
Author(s) -
Aerts J.,
Matas A.,
Sutherland D.,
Kandaswamy R.
Publication year - 2010
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/j.1600-6143.2009.02883.x
Subject(s) - medicine , chylous ascites , chyle , surgery , parenteral nutrition , nephrectomy , complication , ascites , kidney
Chylous ascites as a result of laparoscopic donor nephrectomy (LDN) is a rare complication that carries significant morbidity, including severe protein‐calorie malnutrition and an associated immunocompromised state. We report a patient who underwent hand‐assisted left LDN and subsequently developed chylous ascites. He failed conservative therapy including low‐fat diet with medium‐chain triglycerides (LFD/MCT) and oral protein supplementation as well as strict NPO status with intravenous (IV) total parenteral nutrition (TPN) and subcutaneous (SQ) somatostatin analogue administration. Laparoscopic re‐exploration and intracorporeal suture ligation and clipping of leaking lymph channels successfully sealed the chyle leak. We review the literature to date including diagnosis, incidence, management options, psychosocial aspects and clinical outcomes of chylous ascites after LDN.