title: The application of nutrition support in conservative treatment of chylous ascites after abdominal surgery.
abstract: BACKGROUND
  Chylous ascites is the pathologic leakage of triglycerides-rich lymphatic fluid into the peritoneal cavity. Chylous ascites is a rare complication in abdominal surgery. This study aimed to find a relatively better method for nutrition support in the treatment of chylous ascites after abdominal surgery.
  
  
  METHODS
  This study was a retrospective study. This study retrospectively reviewed patients who underwent abdominal surgery and developed chylous ascites, from the year 2010 to 2014, at the West China Hospital of Sichuan University and the Affiliated Hospital of Zunyi Medical College. Fifty-eight patients who developed chylous ascites after abdominal surgery were included in the study. The clinical effect of somatostatin was evaluated. The differences in the curative efficacy among a daily diet, a low-fat diet supplemented with medium-chain triglyceride (MCT), and total parenteral nutrition (TPN) were also analyzed in this study.
  
  
  RESULTS
  Complete clinical success was reached earlier in patients treated with somatostatin (P<0.001). The tube removal time, the time to resumption of an oral diet, and the length of hospital stay after chylous leakage were significantly different between patients treated with and without somatostatin. The curative efficacies of the enteral nutrition (EN) + MCT plan and the TPN plan were quite similar, with no significant difference, however, were significantly different from the MCT regime, which was the worst. However, using the EN + MCT plan was more cost-effective (P=0.038).
  
  
  CONCLUSIONS
  In treating chylous ascites, EN + MCT instead of TPN was the best nutrition support. Moreover, somatostatin or its analog octreotide should be used immediately. The treatment with somatostatin in combination with EN + MCT is recommended in the conservative treatment of postoperative chylous ascites.
authors.affiliation: Department of Plastic & Vascular Surgery, Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou, People's Republic of China.
authors.forename: Wu
authors.initials: W
authors.lastname: Pan
authors.affiliation: Department of Hepatopancreatobiliary Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.
authors.forename: Shen-Yang
authors.initials: SY
authors.lastname: Cai
authors.affiliation: Department of Hepatopancreatobiliary Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.
authors.forename: Hai-Long
authors.initials: HL
authors.lastname: Luo
authors.affiliation: Department of Plastic & Vascular Surgery, Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou, People's Republic of China.
authors.forename: Shu-Rui
authors.initials: SR
authors.lastname: Ouyang
authors.affiliation: Department of Plastic & Vascular Surgery, Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou, People's Republic of China.
authors.forename: Wen-Duo
authors.initials: WD
authors.lastname: Zhang
authors.affiliation: Department of Plastic & Vascular Surgery, Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou, People's Republic of China.
authors.forename: Zai-Rong
authors.initials: ZR
authors.lastname: Wei
authors.affiliation: Department of Plastic & Vascular Surgery, Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou, People's Republic of China.
authors.forename: Da-Li
authors.initials: DL
authors.lastname: Wang
keywords: chylous ascites; enteral nutrition; medium-chain triglycerides; somatostatin; total parenteral nutrition