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Chylothorax after hepatectomy: a case report.
Yamamoto, Ryusei; Mokuno, Yasuji; Matsubara, Hideo; Kaneko, Hirokazu; Sato, Yozo; Iyomasa, Shinsuke.
Afiliação
  • Yamamoto R; Department of Surgery, Yachiyo Hospital, 2-2-7, Sumiyoshi-cho, Anjo-shi, Aichi, 446-8510, Japan. public.lock.on@gmail.com.
  • Mokuno Y; Department of Surgery, Yachiyo Hospital, 2-2-7, Sumiyoshi-cho, Anjo-shi, Aichi, 446-8510, Japan.
  • Matsubara H; Department of Surgery, Yachiyo Hospital, 2-2-7, Sumiyoshi-cho, Anjo-shi, Aichi, 446-8510, Japan.
  • Kaneko H; Department of Surgery, Yachiyo Hospital, 2-2-7, Sumiyoshi-cho, Anjo-shi, Aichi, 446-8510, Japan.
  • Sato Y; Department of Diagnostic and Interventional Radiology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, 464-8681, Japan.
  • Iyomasa S; Department of Surgery, Yachiyo Hospital, 2-2-7, Sumiyoshi-cho, Anjo-shi, Aichi, 446-8510, Japan.
J Med Case Rep ; 12(1): 347, 2018 Nov 26.
Article em En | MEDLINE | ID: mdl-30474568
BACKGROUND: Chylothorax is the accumulation of chyle within the pleural space. Chylothorax can occur as a complication after multiple different types of surgery, most frequently after thoracic surgery, albeit with an incidence rate of less than 1%. Chylothorax after abdominal surgery is extremely rare, and there are only a few case reports. CASE PRESENTATION: A 74-year-old Japanese woman presented with jaundice. She was diagnosed as having hilar cholangiocarcinoma and underwent right hepatectomy, caudate lobectomy, extrahepatic bile duct resection, and lymph node dissection after preoperative percutaneous transhepatic portal vein embolization. Postoperative liver function was normal. She developed chylous ascites on postoperative day 5, for which conservative treatment was initially effective. Dyspnea developed suddenly on postoperative day 42, and she had a massive right pleural effusion and a small amount of ascites. Management with pleural drainage, total parenteral nutrition, and octreotide injections decreased the chylothorax. However, the chylous effusion reaccumulated on postoperative day 57. As conservative treatments ultimately failed, lymphangiography was performed on postoperative day 62. Lymphangiography with Lipiodol (ethiodized oil) revealed extravasation into the pleural space, but the location of the leak was not identified. There was neither obstruction nor dilation of the thoracic duct. A lymphatic leak in her abdominal cavity was not demonstrated. A chest tube was placed after lymphangiography, and the chylothorax was diminished by postoperative day 71. She was discharged on postoperative day 72. Two and a half years after surgery, she is doing well with no evidence of recurrence of either chylothorax or cancer. CONCLUSIONS: Chylothorax can occur after hepatectomy and pleural effusion should raise suspicion for chylothorax. Lymphangiography may be effective for both diagnosis and treatment in the case of chylothorax after hepatectomy.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações Pós-Operatórias / Neoplasias dos Ductos Biliares / Linfografia / Drenagem / Quilotórax / Colangiocarcinoma / Hepatectomia Tipo de estudo: Etiology_studies / Prognostic_studies Limite: Aged / Female / Humans Idioma: En Revista: J Med Case Rep Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Japão

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações Pós-Operatórias / Neoplasias dos Ductos Biliares / Linfografia / Drenagem / Quilotórax / Colangiocarcinoma / Hepatectomia Tipo de estudo: Etiology_studies / Prognostic_studies Limite: Aged / Female / Humans Idioma: En Revista: J Med Case Rep Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Japão