Octreotide-acetate treatment of chylous ascites after subtotal stomach-preserving pancreatoduodenectomy and portal vein resection—a case report—

Abstract

A 49-year-old male diagnosed with pancreatic head cancer underwent pancreatoduodenectomy and portal vein resection. The operation was successful ; however, after starting oral ingestion from postoperative day 6, he developed a tympanitic abdomen. From the postoperative day 10, over 3500 ml/day of chylous ascites was discharged through the drain. Low and non-fat diet was not effective; from day 30, we started percutaneous administration of octreotide acetate (300μg/day). Octreotide acetate was very effective for the treatment of ascites. The patient was discharged on day 45. Few studies have reported chylous ascites after pancreatoduodenectomy (PD). Chylous ascites is mainly caused by trauma to the cisterna chyli during operation. Although chylous ascites is generally treated by conservative treatment, octreotide acetate may be effective for treating intractable cases.