TY - JOUR
T1 - Definition and classification of chyle leak after pancreatic operation: A consensus statement by the International Study Group on Pancreatic Surgery
AU - Besselink, Marc G.
AU - van Rijssen, L. Bengt
AU - Bassi, Claudio
AU - Dervenis, Christos
AU - Montorsi, Marco
AU - Adham, Mustapha
AU - Asbun, Horacio J.
AU - Bockhorn, Maximillian
AU - Strobel, Oliver
AU - Büchler, Markus W.
AU - Busch, Olivier R.
AU - Charnley, Richard M.
AU - Conlon, Kevin C.
AU - Fernández-Cruz, Laureano
AU - Fingerhut, Abe
AU - Friess, Helmut
AU - Izbicki, Jakob R.
AU - Lillemoe, Keith D.
AU - Neoptolemos, John P.
AU - Sarr, Michael G.
AU - Shrikhande, Shailesh V.
AU - Sitarz, Robert
AU - Vollmer, Charles M.
AU - Yeo, Charles J.
AU - Hartwig, Werner
AU - Wolfgang, Christopher L.
AU - Gouma, Dirk J.
PY - 2017
Y1 - 2017
N2 - Recent literature suggests that chyle leak may complicate up to 10% of pancreatic resections. Treatment depends on its severity, which may include chylous ascites. No international consensus definition or grading system of chyle leak currently is available. The International Study Group on Pancreatic Surgery, an international panel of pancreatic surgeons working in well-known, high-volume centers, reviewed the literature and worked together to establish a consensus on the definition and classification of chyle leak after pancreatic operation. Chyle leak was defined as output of milky-colored fluid from a drain, drain site, or wound on or after postoperative day 3, with a triglyceride content ≥110 mg/dL (≥1.2 mmol/L). Three different grades of severity were defined according to the management needed: grade A, no specific intervention other than oral dietary restrictions; grade B, prolongation of hospital stay, nasoenteral nutrition with dietary restriction, total parenteral nutrition, octreotide, maintenance of surgical drains, or placement of new percutaneous drains; and grade C, need for other more invasive in-hospital treatment, intensive care unit admission, or mortality. This classification and grading system for chyle leak after pancreatic resection allows for comparison of outcomes between series. As with the other the International Study Group on Pancreatic Surgery consensus statements, this classification should facilitate communication and evaluation of different approaches to the prevention and treatment of this complication
AB - Recent literature suggests that chyle leak may complicate up to 10% of pancreatic resections. Treatment depends on its severity, which may include chylous ascites. No international consensus definition or grading system of chyle leak currently is available. The International Study Group on Pancreatic Surgery, an international panel of pancreatic surgeons working in well-known, high-volume centers, reviewed the literature and worked together to establish a consensus on the definition and classification of chyle leak after pancreatic operation. Chyle leak was defined as output of milky-colored fluid from a drain, drain site, or wound on or after postoperative day 3, with a triglyceride content ≥110 mg/dL (≥1.2 mmol/L). Three different grades of severity were defined according to the management needed: grade A, no specific intervention other than oral dietary restrictions; grade B, prolongation of hospital stay, nasoenteral nutrition with dietary restriction, total parenteral nutrition, octreotide, maintenance of surgical drains, or placement of new percutaneous drains; and grade C, need for other more invasive in-hospital treatment, intensive care unit admission, or mortality. This classification and grading system for chyle leak after pancreatic resection allows for comparison of outcomes between series. As with the other the International Study Group on Pancreatic Surgery consensus statements, this classification should facilitate communication and evaluation of different approaches to the prevention and treatment of this complication
U2 - https://doi.org/10.1016/j.surg.2016.06.058
DO - https://doi.org/10.1016/j.surg.2016.06.058
M3 - Article
C2 - 27692778
SN - 0039-6060
VL - 161
SP - 365
EP - 372
JO - Surgery
JF - Surgery
IS - 2
ER -