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A case of intractable massive ascites hepatic lymphorrhea following radical gastrectomy for early gastric cancer

A case of intractable massive ascites hepatic lymphorrhea following radical gastrectomy for early gastric cancer

Journal of Kyoto Prefectural University of Medicine 101(2): 175-180

We experienced severe hepatic lymphorrhea following radical gastrectomy for early gastric cancer in a 62 years old male. It was considered to be caused by the injury of lymphatic vessels when we dissected lymph nodes in the hepatoduodenal ligament. The diagnosis was confirmed by paracentesis and clinical findings which demonstrated grossly serous ascites fluid with a typical chemical composition. It was not chylous ascites but hepatic lymphorrhea. The treatment was begun conservatively at first, and peritoneo-venous shunting (Le Veen shunt) after the conservative treatments did not correct patient's condition. Because of continuation of the massive ascites, reoperation was performed one year and four months later. The patient was cured by surgical ligations of the disrupted lymphatics. Therefore, for the intractable ascites due to lymph nodes dissection in gastric cancer, ligations of the lymphatic vessel are recommended when the consavative treatments are not effective.

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Accession: 006932650

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