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Chyle Leak After Esophageal Surgery

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Gastrointestinal Surgery

Abstract

A chyle leak is a challenging complication following esophageal procedures and occurs as a result of injury to the thoracic duct and its collateral lymphatic channels. The problem commonly presents as a postoperative pleural effusion that is rich in triglycerides. Large quantities, > 2 L/d, of chyle can drain from the site of lymph duct injury and can result in significant fluid and nutritional losses. Initial management involves drainage of the effusion, bowel rest, and total parenteral nutrition (TPN). Less common adjuncts to treatment are available, but if conservative measures fail, operative intervention may become necessary. Surgery typically involves access to the right chest cavity with direct ligation of the thoracic duct.

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Abbreviations

MIE:

Minimally invasive esophagectomy

NPO:

Nil per os

TPN:

Total parenteral nutrition

VATS:

Video-assisted thoracoscopic surgery

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Author information

Authors and Affiliations

  1. Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA

    Elena M. Ziarnik MD

  2. Department of Thoracic Surgery, Vanderbilt University, 37232-4682, Nashville, 609 Oxford House, 1313 21st St Avenue SouthTN, USA

    Assoc. Prof. Jonathan C. Nesbitt MD

Authors
  1. Elena M. Ziarnik MD
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  2. Assoc. Prof. Jonathan C. Nesbitt MD
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Corresponding author

Correspondence to Jonathan C. Nesbitt MD .

Editor information

Editors and Affiliations

  1. Division of Surgical Oncology, Johns Hopkins Hospital, Baltimore, Maryland, USA

    Timothy M. Pawlik

  2. Division of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia, USA

    Shishir K. Maithel

  3. Professor of Surgery, Division of Surgical Oncology, University of Miami, Miller School of Medicine, Sylvester Comprehensive Cancer Center, Miami, Florida, USA

    Nipun B. Merchant

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Ziarnik, E., Nesbitt, J. (2015). Chyle Leak After Esophageal Surgery. In: Pawlik, T., Maithel, S., Merchant, N. (eds) Gastrointestinal Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2223-9_5

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  • DOI: https://doi.org/10.1007/978-1-4939-2223-9_5

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  • Publisher Name: Springer, New York, NY

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  • Online ISBN: 978-1-4939-2223-9

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