耳鼻咽喉科臨床
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
臨床
ソマトスタチンアナログが奏功した術後性頸部乳び漏例
上田 奈津子久世 文也水田 啓介西堀 丈純青木 光広伊藤 八次
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2014 年 107 巻 7 号 p. 553-556

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There are several reports showing the effect of a somatostatin analog in postoperative chylous leakage after gastrointestinal surgery and thoracic surgery. We treated a case with a postoperative refractory chylous leakage with a somatostatin analog. The patient was a 63-year-old man. We performed lymph node resection including the venous angle for metastatic cervical lymph node recurrence from tongue cancer. We performed conservative treatment with a ban on food and drink per os, total parenteral nutrition and applied local pressure to the neck chylous leakage. Because the neck chylous leak reached 1321 ml per day, we carried out thoracic duct ligation on the 3rd day after surgery. The chylous leak decreased temporarily after surgery, but increased again to 925 ml per day. Chylous leakage was stopped after the administration of a somatostatin analog for 5 days. We considered that the use of the somatostatin analog in addition to conservative conventional treatment and surgical treatment is one possible strategy to deal with postoperative refractory chylous leakage.

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