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.
CITATION STYLE
Corradini, S., Liebig, S., Niemoeller, O. M., Zwicker, F., & Lamadé, W. (2015). Erfolgreiche strahlentherapeutische Behandlung eines Chyloperitoneums nach Pankreatikoduodenektomie. Strahlentherapie Und Onkologie, 191(5), 448–452. https://doi.org/10.1007/s00066-014-0805-z
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