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Definition and classification of chyle leak after pancreatic operation: A consensus statement by the International Study Group on Pancreatic Surgery

Lookup NU author(s): Richard Charnley

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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.

Publication metadata

Author(s): Besselink MG, van Rijssen LB, Bassi C, Dervenis C, Montorsi M, Adham M, Asbun HJ, Bockhorn M, Strobel O, Buchler MW, Busch OR, Charnley RM, Conlon KC, Fernandez-Cruz L, Fingerhut A, Friess H, Izbicki JR, Lillemoe KD, Neoptolemos JP, Sarr MG, Shrikhande SV, Sitarz R, Vollmer CM, Yeo CJ, Hartwig W, Wolfgang CL, Gouma DJ, Int Study Grp Pancreatic Surg

Publication type: Article

Publication status: Published

Journal: Surgery

Year: 2017

Volume: 161

Issue: 2

Pages: 365-372

Print publication date: 01/02/2017

Online publication date: 28/09/2016

Acceptance date: 22/06/2016

ISSN (print): 0039-6060

ISSN (electronic): 1532-7361

Publisher: Elsevier

URL: http://dx.doi.org/10.1016/j.surg.2016.06.058

DOI: 10.1016/j.surg.2016.06.058

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