Chylous ascites is an accumulation of lymphatic fluid within the peritoneal cavity due to trauma or to an obstruction on the lymphatic system. Postoperative chylous ascites is a rare complication of abdominal surgery. It is frequently reported after retroperitoneal dissections and results in high morbidity and mortality. However, there have been few report of such a complication following a radical gastrectomy. Therefore, we review the clinical analysis and treatment of chylous ascites based on our experience.

From July 1992 to June 2001, we treated 13 cases of chylous ascites after operations for gastric cancer. We reviewed medical charts of those patients retrospectively.

The incidence of chylous ascites after operations for gastric cancer was 0.83% (13/1552). The mean time from ingestion of a meal after the operation to the development of symptoms was 2 days (range: 1~6 days). Conservative treatment by fasting, total parenteral nutrition (TPN), and repeated paracentesis was successful in all patients. The mean time from diagnosis to complete resolution was 25 days (range: 2~105 days).

Chylous ascites should be considered in any patient with a typical milky color of drainage who has recently undergone radical gastrectomy. Treatment with fasting, TPN, and repeated paracentesis usually is successful.