Management of Chyle Leaks Following Pancreatic Resection

Abstract

Chyle leak is an uncommon but potentially lethal complication associated with pancreatectomy. An important distinction should be made between chylous ascites and a contained chyle leak since the mortality from the former is significantly higher. Most chyle leaks will resolve within a few weeks of diagnosis with conservative management that includes initiation of a low-fat diet or NPO status plus TPN and proper drain management. Refractory chyle leaks are most often chylous ascites and may require interventions such as lymphoscintigraphy with placement of glue/coils or surgery. Surgical options for refractory chyle leaks include exploration with an attempt at ligating the disrupted lymphatic or placement of a peritoneovenous shunt.