Abstract:

Prevention and management of lymphorrhea or chylorrhea after gastric surgeries        CAO Hui，ZHAO En-hao. Department of Gastrointestinal Surgery，Ren Ji Hospital，Shanghai Jiao Tong University School of Medicine，Shanghai 200127，China
Corresponding author：CAO Hui，E-mail: caohuishcn@hotmail.com
Abstract    Lymphorrhea or chylorrhea is one of the complications after gastric surgeries，which occurs as a consequence of disruption of abdominal regional lymphatic system and leakage of lymphatic fluid. The iatrogenic injury of lymphatic ducts is one of the most common causes of lymphorrhea or chylorrhea. Conservative treatment should be recommended as the main therapies including dietary restriction，paracentesis and continuous drainage，correction of anemia and hypoalbuminemia，total parenteral nutrition combined with somatostatin. Surgery such as lymphatic duct ligation or suturing is only reserved for patients that fail conservative management. Interventional therapy such as lymphangiography or embolization and laparoscopic surgery still need further investigations in the future to assess the outcomes.

Key words: gastrectomy, lymphorrhea, chylorrhea

摘要：

淋巴漏和乳糜漏是胃手术后的并发症之一，主要由于区域淋巴循环途径被破坏引起淋巴液外漏所引起，术中未能正确地处理离断的淋巴管造成医源性损伤是重要的原因之一，也是预防淋巴漏和乳糜漏的重点。非手术治疗在淋巴漏和乳糜漏的治疗中成为首选，严格的饮食控制、保持引流通畅、纠正贫血和低蛋白血症、给予全肠外营养和生长抑素是治疗的关键。手术治疗则主要用于保守治疗失败的病人，确切地结扎或缝扎淋巴管漏口才能确保手术的成功。介入治疗和腹腔镜手术用于淋巴漏和乳糜漏将成为有益的尝试和探索。

关键词: 胃切除术, 淋巴漏, 乳糜漏