Chylous ascites: treated with total parenteral nutrition and somatostatin.
OBJECTIVE
To determine the effects of total parenteral nutrition and somatostatin on patients with chylous ascites.


METHODS
Five patients were diagnosed with chylous ascites on the basis of laboratory findings of ascites sample from Nov 1999 to May 2003. Total parenteral nutrition and somatostatin or its analogue was administered to 4 patients, while the other one only received total parenteral nutrition. All the patients had persistent peritoneal drainage, with the quantity and quality of drainage fluid observed daily. Necessary supportive treatments were given to the patients individually during the therapy.


RESULTS
Two of 4 patients who received somatostatin therapy obtained complete recovery within 10 d without any recurrence while on a normal diet. In these 2 patients, the peritoneal drainage reduced to zero in one and the other's decreased from 2,000 mL to 80 mL with a clear appearance and negative qualitative analysis of chyle. Recurrent chylous ascites, though relieved effectively by the same method every time, developed in one patient with advanced pancreatic cancer. The other patient's lymphatic fistula was blocked with the fibrin glue after conservative treatment. The patient who only received total parenteral nutrition was cured 24 d after therapy.


CONCLUSIONS
Total parenteral nutrition along with somatostatin can relieve the symptoms and close the fistula in patients with chylous ascites rapidly. It appears to be an effective therapy available for the treatment of chylous ascites caused by various disorders.
Institute of General Surgery, Jinling Hospital, 305 Zhongshan East Road, Nanjing 210002, Jiangsu Province, China.
Qi
Q
Huang
Zhi-Wei
ZW
Jiang
Jun
J
Jiang
Ning
N
Li
Jie-Shou
JS
Li
D000328:Adult; D000368:Aged; D002915:Chylous Ascites / Q000178:diet therapy* / Q000188:drug therapy*; D005260:Female; D006728:Hormones / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total; D013004:Somatostatin / Q000008:administration & dosage*; D016896:Treatment Outcome
D006728:Hormones; D013004:Somatostatin