Hepatic lymphorrhea rarely occurs after surgery and only 8 cases of this disease have been seen in the Japanese literature. This paper describes such a rare case of intractable hepatic lymphorrhea after an operation for a gastric cancer.
A 59-year-old man was admitted to the hospital because of poor appetite. On November 21 1991, the patient underwent subtotal gastrectomy under a diagnsosis of gastric cancer. After the operation ascites appeared and repeated paracenteses of the ascites did not yield any response. Lymphangiography through the lymph vessel of the dosum of the foot revealed no lymphorrhea. Since the ascites was yellow and transparent and involved cells were all lymphocytes, hepatic lymphorrhea was suspected. On July 20 1992 laparotomy was performed. Lymphatic leakage was found from the subhepatic space, but ligature of the lymphatic vessel was impossible. After isozine solution and antibiotics were applied, followed by scattering of fibrin paste to the same region, the operative wound was closed. Postoperative course was uneventful without any collection of ascites. The patient was discharged from the hospital.