title: The community management of chylous fistula using a pancreatic lipase inhibitor (orlistat).
abstract: We describe two innovative ideas in the treatment of iatrogenic chyle leak. The first is the early use of a pancreatic lipase inhibitor (Orlistat) to reduce fat absorption and chyle production, with consequent faster fistula healing. The second is the treatment of these patients at home in the community by district nurses backed by the hospital staff. This domiciliary approach has a positive psychological effect on the patient, permits the patient to take responsibility for their treatment, and reduces hospital length of stay minimising patient exposure to nosocomial infections.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Lancashire Teaching Hospitals NHS Trust, Royal Preston Hospital, Preston, United Kingdom. a.belloso@btinternet.com
authors.forename: Antonio
authors.initials: A
authors.lastname: Belloso
authors.forename: Kasirajan
authors.initials: K
authors.lastname: Saravanan
authors.forename: John
authors.initials: J
authors.lastname: de Carpentier
mesh_terms: D001294:Attitude to Health; D002913:Chyle / Q000187:drug effects*; D018752:Diet, Fat-Restricted; D004322:Drainage; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D005402:Fistula / Q000451:nursing / Q000628:therapy*; D006699:Home Care Services; D006801:Humans; D007049:Iatrogenic Disease; D007783:Lactones / Q000627:therapeutic use*; D007902:Length of Stay; D008049:Lipase / Q000037:antagonists & inhibitors*; D008206:Lymphatic Diseases / Q000451:nursing / Q000628:therapy*; D000077403:Orlistat; D012648:Self Care; D013897:Thoracic Duct / Q000187:drug effects / Q000293:injuries; D014945:Wound Healing / Q000187:drug effects
chemical_list: D004791:Enzyme Inhibitors; D007783:Lactones; D000077403:Orlistat; D008049:Lipase