title: [The diagnosis and therapy of chylous ascites].
abstract: OBJECTIVE
  To discuss the diagnosis and therapy of chylous ascites.
  
  
  METHODS
  To diagnose 40 patients of chylous ascite with regular test and quantitative analysis of chyle, direct lymphangiography, CT (immediately after direct lymphangiography), lymphangioscintigraphy, MRI. Twenty-two patients received conservative therapy, 18 patients received retroperitoneal lymphangiectomy and (or) lymph-vein shunting.
  
  
  RESULTS
  Lymphatic dysplasia and chylous reflux were found in almost every patient, total parenteral nutrition showed good results. Followed up from 1 month to 5 years, in conservative therapy group, 9 patients were controlled well clinically, the condition of 6 patients was improved better. Seven patients showed no effect. In operation group, 11 patients were controlled well clinically. Four patients got mitigated. Total 7 patients died, although 4 of them ameliorated temporarily.
  
  
  CONCLUSIONS
  Direct lymphangiography, CT (immediately after direct lymphangiography) are the most important diagnosis methods. The influence of the therapy to the malformed lymphatic system of patients should be well considered. Lymph-vein shunting, such as thoracic duct-left external jugular vein anastomosis, gastroenteral or retroperitoneal lymphatics-testicular or ovarian vein anastomosis, could improve the circulation of lymph and chyle of patients. Lymphatic microsurgery will play more and more important roles in the treatment of chylous diseases.
authors.affiliation: Department of Lymphatic Surgery, Beijing Gongan Hospital, Beijing 100006, China. 80852swb@sina.com
authors.forename: Wen-bin
authors.initials: WB
authors.lastname: Shen
authors.forename: Yu-guang
authors.initials: YG
authors.lastname: Sun
authors.forename: Song
authors.initials: S
authors.lastname: Xia
authors.forename: Guo-fu
authors.initials: GF
authors.lastname: Wu
authors.forename: Wan-de
authors.initials: WD
authors.lastname: Geng
authors.forename: Ying-xian
authors.initials: YX
authors.lastname: Sun
authors.forename: Kun
authors.initials: K
authors.lastname: Chang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002915:Chylous Ascites / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D042601:Lymphatic Vessels / Q000601:surgery; D008220:Lymphography; D008279:Magnetic Resonance Imaging; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D010289:Parenteral Nutrition, Total; D014057:Tomography, X-Ray Computed