Clinical Study And Analysis About Chylous Leakage After Operation For Gastric Cancer

Objectives:To find out the reasons and treatments of chylous leakage after operation for gastric cancer, we collected 424 cases of patients suffered with gastric cancer from January,2014 to December,2014,32 cases were diagnosed with chylous leakage after the operation, and made a retrospective analysis.Patients and Methods:We collected 424 cases that were taken the open service operation for gastric cancer in Qilu hospital, Shandong University.32 cases were diagnosed with chylous leakage by the milk white or grayish white drainage after the operation. We studied and analyzed the relationship between chylous leakage and the patients’ gender, age, different operation, TNM stage, operation time, the number of lymph node dissection, albumin level after operation, suffered with the DM, etc.Result:32 cases were found out chylous leakage (32/424,7.55%),16 male (16/296, 5.41%) and 16 female (16/128,12.50%); 8 cases were carried out proximal gastrectomy (8/116,6.90%),16 total gastrectomy (16/144,11.11%),8 distal gastrectomy (8/164,4.88%); 4 cases in the stage Ⅰ of the tumor phase (4/56,7.14%), no chylous leakage in stage Ⅱ,24 in stage Ⅲ (24/248,9.68%),4 in stage IV (4/64, 6.25%); 4 cases suffered with the DM before the operation (4/20,20.00%), the other 28 cases didn’t have the complication (28/404,6.93%). All patients had no other complications except chylous leakage, which were found after changing from TPN to EN, one or two days later, diagnosed by the Chyle test. All patients got drainage and symptomatic treatment, those suffered infection got antibacterial drugs, and were cured in one month after the operation. Of all the studied elements, gender, age, TNM stage, the number of lymph node dissection and albumin level have obviously statistical significance with the chylous leakage (P<0.05), while different operation, operation time and the DM have no clear correlation with it (P>0.05).Conclusions:The occurrence of chylous leakage after operation for gastric cancer has correlation with gender, age, TNM stage, the number of lymph node dissection and albumin level. Some behaviors that stimulate the gastrointestinal tract to wriggle, for example, EN can promote the secretion of lymph. Drainage and nutrition support therapy can be beneficial to the recovery of chylous leakage, and antibacterial drugs are essential for those suffered with infection. Emphasis of the anatomy of lymph ducts, silk ligation, use of protein glue and the increase of albumin level can decrease the incidence of chylous leakage.