中华肝脏外科手术学电子杂志2016，Vol.5Issue(5)：300-303,4.DOI:10.3877/cma.j.issn.2095-3232.2016.05.007
肝移植术后乳糜性腹水的诊治经验
Diagnosis and treatment experience of chylous ascites after liver transplantation
摘要
Abstract
ObjectiveTo investigate the incidence, diagnosis and treatment experience of chylous ascites after liver transplantation (LT). MethodsClinical data of 18 patients developing chylous ascites out of 241 patients undergoing allogeneic orthotopic LT in the Third Afifliated Hospital of Sun Yat-sen University between June 2012 and April 2015 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among the patients, 15 were males and 3 were females with the age ranging from 26 to 63 years old and the median age of 44 years old. All patients underwent complete cadaveric LT for the ifrst time and the procedure was modiifed piggyback LT. The clinical manifestations, the volume and time of peritoneal fluid drainage, treatments and clinical outcome of the patients were observed.ResultsThe incidence of chylous ascites after LT was 7.5%(18/241), and the typical manifestations were large quantity of turbid ascites with chyle color observed when the patients began to take food 1 week after surgery, and the chylous test was positive. The median of postoperative diagnosis time was 11(7-27) d. All patients received the conservative treatments, including fasting or a small mount of low-fat liquid diet, parenteral nutrition in combination of somatostatin. The time of removing peritoneal drainage tube was 21(11-42) d, and the postoperative length of hospital stay was 41(22-59) d. Seventeen patients healed and discharged while 1 patient died due to multidrug-resistantAcinetobacter baumannii pneumonia.Conclusions Chylous ascites after LT is bad for the postoperative rehabilitation, and it can be conifrmed by large quantity of chylous ascites and positive chylous test. Conservative treatments like somatostatin in combination with parenteral nutrition should be the ifrst choice.关键词
肝移植/乳糜性腹水/诊断/生长抑素Key words
Liver transplantation/Chylous ascites/Diagnosis/Somatostatin引用本文复制引用
汪国营,易述红,李华,杨扬,陈规划,安玉玲,张英才,冯啸,安太来,唐晖,姚嘉,杨卿,傅斌生..肝移植术后乳糜性腹水的诊治经验[J].中华肝脏外科手术学电子杂志,2016,5(5):300-303,4.基金项目
广东省自然科学基金(2015A030312013，2015A030313038)；广东省科技计划项目(2014B020228003，2014A020211015)；广州市科技计划项目(201400000001-3，158100076，2014J4100183) （2015A030312013，2015A030313038）
