Erschienen in:
01.05.2015 | Case Study
Successful radiation treatment of chylous ascites following pancreaticoduodenectomy
verfasst von:
Dr. med. univ. Stefanie Corradini, Dr. med. Sylke Liebig, Dr. med. Olivier M Niemoeller, Dr. med. Felix Zwicker, Dr. med. Wolfram Lamadé
Erschienen in:
Strahlentherapie und Onkologie
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Ausgabe 5/2015
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Abstract
Chylous ascites is a rare complication following pancreaticoduodenectomy. We report on a case of chylous ascites following pancreaticoduodenectomy in a 76-year-old patient diagnosed with pancreatic cancer. There are various known conservative management strategies, including dietary measures or total parenteral nutrition. Unfortunately, conservative treatment—with total parenteral nutrition and fasting over a period of 4 weeks—was not successful in the present case. The daily output volume of chylous ascites was up to 2500 ml/day. Based on clinical experiences with successfully treated lymphocutaneous fistulas, low-dose radiotherapy was initiated. External beam radiotherapy comprising a total dose of 8.0 Gy to the paraaortic lymph node region was administered in daily single fractions of 1.0 Gy (five fractions/week). Throughout the course of external beam radiotherapy, the secretion of abdominal ascites rapidly decreased, resulting in complete resolution after 2 weeks. There was no clinical evidence of chylous ascites on follow-up. As a result of this experience, we believe that external beam radiotherapy should be considered as an alternative therapy in refractory cases of chylous ascites.