Acta Scientific Gastrointestinal Disorders (ASGIS)(ISSN: 2582-1091)

Review Article Volume 7 Issue 7

Chylous Ascites Post Colorectal Resections

Melissa Kyriakos Saad1, Karam Karam2*, Elias Fiani3, Charbel Fares4, Elias Saikaly5

1Saint George Hospital University Medical Center, Beirut, Lebanon
2Saint George Hospital University Medical Center, Beirut, Lebanon
3Department of Gastroenterology, Saint George Hospital University Medical Center, Beirut, Lebanon
4Saint George Hospital University Medical Center, Department of radiology, Beirut, Lebanon
5Saint George Hospital University Medical Center, Department of General Surgery, Beirut, Lebanon, Saint George University of Beirut, Beirut, Lebanon

*Corresponding Author: Karam E Karam, Saint George Hospital University Medical Center, Beirut, Lebanon.

Received: May 24, 2024; Published: June 10, 2024


An infrequently seen and rarely reported complication after colorectal surgery is chylous ascites. It is a clinical subject of increasing significance after colorectal surgery especially that once it occurs it impacts the postoperative recovery and may lead to malnutrition, electrolytes imbalances, protein and lymphocyte loss. However, with the advent of extended lymphadenectomy and adaption of total mesocolic excision in colorectal resections, more cases of chylous ascites are being seen and reported. It is generally regarded as postoperative buildup of chyle in the peritoneal cavity, characterized by the appearance of milky fluid and elevated triglyceride levels in the surgically placed drains. Chylous ascites post colorectal surgery is considered an infrequent event, and due to its rarity the etiology, the diagnosis and management options are not well established with no universal guidelines present to guide its treatment. Having said this, the goal of this article is to review the medical literature regarding chylous ascites post colorectal surgery in order to elucidate the definition, the grading and describe its incidence, the clinical presentation, risk factors, and the management options of this complication.

Keywords: Chylous Ascites; Resections; Post Colorectal


  1. van der Gaag NA., et al. “Chylous ascites after pancreaticoduodenectomy: introduction of a grading system”. Journal of the American College of Surgeons 207 (2008): 751-757.
  2. Kaas R., et al. “Chylous ascites after oncological abdominal surgery: incidence and treatment”. European Journal of Surgical Oncology 27 (2001): 187-189.
  3. Aalami OO., et al. “Chylous ascites: a collective review”. Surgery 128 (2000): 761-778.
  4. Leibovitch I., et al. “The diagnosis and management of postoperative chylous ascites”. Journal of Urology167 (2002): 449-457.
  5. Evans JG., et al. “Chylous ascites after postchemotherapy retroperitoneal lymph node dissection: review of the M. D. Anderson experience”. Journal of Urology 176 (2006): 1463-467.
  6. Bhat AL and Lowery GL. “Chylous injury following anterior spinal surgery: case reports”. European Spine Journal 6 (1997): 270-272.
  7. Ng ZQ and He B. “A Proposed Classification System and Therapeutic Strategy for Chyle Leak After Laparoscopic Living-Donor Nephrectomy: A Single-Center Experience and Review of the Literature”. Experimental and Clinical Transplantation 16 (2018): 143-149.
  8. Matsuda T., et al. “Chylous ascites as a complication of laparoscopic colorectal surgery”. Asian Journal of Endoscopic Surgery 6 (2013): 279-284.
  9. Nishigori H., et al. “Postoperative chylous ascites after colorectal cancer surgery”. Surgery Today 42 (2012): 724-728.
  10. Baek SJ., et al. “Incidence and risk factors of chylous ascites after colorectal cancer surgery”. The American Journal of Surgery 206 (2013): 555-559.
  11. Lee SY., et al. “Chylous ascites after colorectal cancer surgery: risk factors and impact on short-term and long-term outcomes”. Langenbeck's Archives of Surgery 401 (2016): 1171-1177.
  12. Chi P. “Diagnosis and treatment of abdominal chyle leak after resection of colorectal cancer”. Zhonghua Wei Chang Wai Ke Za Zhi 15 (2012): 323-324.
  13. Lu XR., et al. “Treatment of chyle leak following radical resection for colorectal cancer”. Zhonghua Wei Chang Wai Ke Za Zhi 13 (2010): 808-810.
  14. Gustafsson UO., et al. “Guidelines for Perioperative Care in Elective Colorectal Surgery: Enhanced Recovery After Surgery (ERAS®) Society Recommendations: 2018”. World Journal of Surgery 43 (2019): 659-695.
  15. Tulunay G., et al. “Chylous ascites: analysis of 24 patients”. Gynecologic Oncology 127 (2012): 191-197.
  16. Evans JG., et al. “Chylous ascites after postchemotherapy retroperitoneal lymph node dissection: review of the M. D. Anderson experience”. Journal of Urology 4 Pt 1 (2006): 1463-1467.
  17. Baniel J., et al. “Management of chylous ascites after retroperitoneal lymph node dissection for testicular cancer”. Journal of Urology5 Pt 1 (1993): 1422-1444.
  18. Pabst 3rd TS., et al. “Management of chyloperitoneum after abdominal aortic surgery”. The American Journal of Surgery 166 (1993): 194-198.
  19. Assumpcao L., et al. “Incidence and management of chyle leaks following pancreatic resection: a high volume singlecenter institutional experience”. Journal of Gastrointestinal Surgery 12 (2008): 1915-1923.
  20. Yilmaz M., et al. “Chylous ascites after liver transplantation: incidence and risk factors”. Liver Transplantation 18 (2012): 1046-1052.
  21. Kuboki S., et al. “Chylous ascites after hepatopancreatobiliary surgery”. British Journal of Surgery 100 (2013): 522-527.
  22. Noji T., et al. “Early enteral feeding after distal pancreatectomy may contribute to chyle leak”. Pancreas 41 (2012): 331-333.
  23. Malik HZ., et al. “Chyle leakage and early enteral feeding following pancreatico-duodenectomy: management options”. Digestive Surgery 24 (2007): 418-422.
  24. Capocasale E., et al. “Incidence, diagnosis, and treatment of chylous leakage after laparoscopic live donor nephrectomy”. Transplantation 93 (2012): 82-86.
  25. Chan KY., et al. “Chylous ascites after anterior resection for rectal carcinoma: a rare but significant incident”. Asian Journal of Surgery 1 (2006): 46-48.
  26. Alejandre-Lafont E., et al. “Effectiveness of therapeutic lymphography on lymphatic leakage”. Acta Radiologica 52 (2011): 305-311.
  27. Deso S., et al. “Lymphangiography in the diagnosis and localization of various chyle leaks”. CardioVascular and Interventional Radiology 35 (2012): 117-126.
  28. Kos S., et al. “Lymphangiography: forgotten tool or rising star in the diagnosis and therapy of postoperative lymphatic vessel leakage”. CardioVascular and Interventional Radiology 30 (2007): 968-973.
  29. Matsumoto T., et al. “The effectiveness of lymphangiography as a treatment method for various chyle leakages”. The British Journal of Radiology 82 (2009): 286-290.
  30. Kamiya K., et al. “Intraoperative indocyanine green fluorescence lymphography, a novel imaging technique to detect a chyle fistula after an esophagectomy: report of a case”. Surgery Today 5 (2009): 421-424.
  31. Nishizawa K., et al. “Successful laparoscopic management of chylous ascites following laparoscopic radical nephrectomy”. International Journal of Urology 5 (2006): 619-621.


Citation: Karam E Karam., et al. “Chylous Ascites Post Colorectal Resections". Acta Scientific Gastrointestinal Disorders 7.7 (2024): 14-17.


Copyright: © 2024 Karam E Karam., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Acceptance rate35%
Acceptance to publication20-30 days

Indexed In

News and Events

  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is June 25, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US