Definition and classification of chyle leak after pancreatic operation

• Verfasst von: Besselink, Marc G. [VerfasserIn]
• Verfasst von: Strobel, Oliver [VerfasserIn]
• Verfasst von: Büchler, Markus W. [VerfasserIn]
• Titel: Definition and classification of chyle leak after pancreatic operation
• Titelzusatz: a consensus statement by the International Study Group on Pancreatic Surgery
• Verf.angabe: Marc G. Besselink, L. Bengt van Rijssen, Claudio Bassi, Christos Dervenis, Marco Montorsi, Mustapha Adham, Horacio J. Asbun, Maximillian Bockhorn, Oliver Strobel, Markus W. Büchler, Olivier R. Busch, Richard M. Charnley, Kevin C. Conlon, Laureano Fernández-Cruz, Abe Fingerhut, Helmut Friess, Jakob R. Izbicki, Keith D. Lillemoe, John P. Neoptolemos, Michael G. Sarr, Shailesh V. Shrikhande, Robert Sitarz, Charles M. Vollmer, Charles J. Yeo, Werner Hartwig, Christopher L. Wolfgang, and Dirk J. Gouma
• Jahr: 2017
• Jahr des Originals: 2016
• Umfang: 8 S.
• Fussnoten: Gesehen am 08.06.2018 ; Available online 28 September 2016
• Titel Quelle: Enthalten in: Surgery
• Ort Quelle: Amsterdam [u.a.] : Elsevier, 1995
• Jahr Quelle: 2017
• Band/Heft Quelle: 161(2017), 2, Seite 365-372
• ISSN Quelle: 1532-7361
• DOI: doi:10.1016/j.surg.2016.06.058
• Datenträger: Online-Ressource
• Sprache: eng
• Bibliogr. Hinweis: Kommentar in: Rijssen, L. Bengt van: Reply to a letter to the editor regarding the International Study Group on Pancreatic Surgery definition and classification of chyle leak after pancreatic operation
• K10plus-PPN: 1576174360

Abstract

Background Recent literature suggests that chyle leak may complicate up to 10% of pancreatic resections. Treatment depends on its severity, which may include chylous ascites. No international consensus definition or grading system of chyle leak currently is available. Methods The International Study Group on Pancreatic Surgery, an international panel of pancreatic surgeons working in well-known, high-volume centers, reviewed the literature and worked together to establish a consensus on the definition and classification of chyle leak after pancreatic operation. Results Chyle leak was defined as output of milky-colored fluid from a drain, drain site, or wound on or after postoperative day 3, with a triglyceride content ≥110 mg/dL (≥1.2 mmol/L). Three different grades of severity were defined according to the management needed: grade A, no specific intervention other than oral dietary restrictions; grade B, prolongation of hospital stay, nasoenteral nutrition with dietary restriction, total parenteral nutrition, octreotide, maintenance of surgical drains, or placement of new percutaneous drains; and grade C, need for other more invasive in-hospital treatment, intensive care unit admission, or mortality. Conclusion This classification and grading system for chyle leak after pancreatic resection allows for comparison of outcomes between series. As with the other the International Study Group on Pancreatic Surgery consensus statements, this classification should facilitate communication and evaluation of different approaches to the prevention and treatment of this complication.