A Massive Chylous Ascites With Severe Morbidity After Laparoscopic Donor Nephrectomy and Successful Treatment With Total Parenteral Nutrition and Octreotide.

Abstract

Kidney transplant is a choice option for treatment of chronic kidney failure because it is associated with cost-effective and normal quality of life. To increase the number of living kidney donors, laparoscopic and minimal invasive modalities have been introduced. Here, we present a case of a living donor with an extremely rare complication after laparoscopic donor nephrectomy that presented as massive chylous ascites. Kidney donor operation can be performed with the use of 3 modalities: traditional open, laparoscopic, and open with minimally invasive. All 3 modalities may be associated with some complications, including wound infection, hemorrhaging, and deep vein thrombosis. With regard to rare complications of chylous ascites after laparoscopic donor nephrectomy, few cases have been reported. To our knowledge, only 5 such cases have been reported thus far. Our patient, a 29-year-old male donor, received left donor nephrectomy via laparoscopy and was discharged 4 days later in good condition and without any problems. However, 3 weeks later, he presented with abdominal pain. During evaluation, massive ascites in the abdomen was observed and he was hospitalized. Abdominal paracentesis was performed and chylous ascites was diagnosed, and he was treated with conservative treatment, which included combined total parenteral nutrition, paracentesis, and octreotide. For this rare complication of massive chylous ascites afterlaparoscopic donor nephrectomy, treatment with total parenteral nutrition and octreotide can be used; however, care must be taken regarding clipping of the lymph vessel of hilum of the kidney during nephrectomy.