A Case of Successful Octreotide Treatment for Chylous Leakage after Neck Dissection

Abstract

Recently, octreotide has been reported to be effective in the treatment of some cases of chylothorax and chylous peritoneal effusion. However, there are few reports on the use of octreotide in the fields of otorhinolaryngology and head-and-neck surgery. Herein, we present a case in which octreotide treatment was found to be beneficial to arrest chylous fluid leakage following neck dissection. A 59-year-old woman with thyroid cancer and neck lymph node metastasis underwent total thyroidectomy with bilateral conservative D3a neck dissection. During the operation, the thoracic duct was cut and the tissue surrounding the chylous leakage was sutured and ligated. The patient was started on a low-fat diet on the third postoperative day (POD), and immediately, a large quantity of chylous fluid was found to drain out of the drainage tube. Intermittent subcutaneous administration of octreotide at a dose of 100 μg twice a day was started on the fourth POD. The chylous leakage from the drainage tube started to decrease noticeably from the day after the start of octreotide administration, almost stopping completely on the seventh POD. On the 12th POD, oral intake was resumed, however, no chylous fluid leakage was detected. The patient was discharged from the hospital on the 24th POD. Thus, octreotide appears to be extremely effective for controlling chylous leakage after operation, and treatment with octreotide should be considered before attempting any surgical intervention.