Successful management of chyloperitoneum after laparoscopic adjustable gastric banding in 2 patients

Lymphatic Chyle Duct Injury and Identification During Laparoscopic Sleeve Gastrectomy Preventing Postoperative Chylous Ascites

We present a case of intraoperative detection of an iatrogenic chyle duct injury during laparoscopic sleeve gastrectomy. The chyle duct injury was identified and managed by ligature, preventing postoperative chylous ascites.

Chyloperitoneum and Chylothorax Following Bariatric Surgery: a Systematic Review

Chyloperitoneum and chylothorax (ChP/ChT) are rare complications after bariatric surgery. This systematic review aims to evaluate the incidence, cause, treatment, and outcome of ChP and ChT after bariatric surgery. This review investigates published English language scientific literature systematically in an attempt to answer these questions. Our literature search revealed 66 studies, of which 23 were included. There were a total of 40 patients (38, ChP; 2, ChT). Eighteen of 40 (43.9%) patients were treated laparoscopically, and one patient (2.44%) underwent thoracoscopy and ligation of the thoracic duct. Both ChP and ChT are rare complications after bariatric surgery.

Lymphatic leakage after laparoscopic sleeve gastrectomy; presentation, management and review of the literature

The lymphatic system is a vital network of lymphatic vessels that carries liquid fluids, long-chain fatty acids and proteins from capillaries back to the vascular system and clears interstitial debris and bacteria. Lymphatic leakage is a condition not uncommon after many abdominal surgeries. It can lead to immunodeficiency and nutritional abnormalities. Moreover, it has high morbidity and mortality, ranging between 40% and 70%, depending on the presence of an underlying condition. A few lymphatic leakage cases after bariatric surgery have been reported in the literature. We report the first case of lymphatic leakage after sleeve gastrectomy, which was treated with conservative treatment.

Long standing biliary colic masking chylous ascites in laparoscopic roux-en-Y gastric bypass; a case report

Background

Chylous ascites is considered to be an intra-abdominal collection of creamy colored fluid with triglyceride content of > 110 mg/dL. Chylous ascites is an uncommon but serious complication of numerous surgical interventions. However, it is a rare complication of LRYGB. An internal hernia limb defect is thought to be the underlying etiology, where the hernia will cause lymphatic vessel engorgement and lymphatic extravasation.

Case presentation

We report a case of a 29 years old male with a 9 year history of laparoscopic Roux en y gastric bypass (LRGYB), presenting with recurrent abdominal pain for 2 months radiating to the right shoulder. Ultrasound examination revealed gallstones and the patient was subsequently admitted for laparoscopic cholecystectomy. Intraoperatively, whitish colored fluid, high in triglycerides content was aspirated. During exploration, an internal hernia limb defect was found and corrected.

Conclusion

Post LRGYB patients with symptoms of recurrent abdominal pain should be suspected for chylous ascites reflecting an internal hernia.