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BMJ Case Rep. 2010; 2010: bcr0820092141.
Published online 2010 January 13. doi:  10.1136/bcr.08.2009.2141
PMCID: PMC3029240
Novel treatment (new drug/intervention; established drug/procedure in new situation)

Laparoscopic management of chylous ascites following laparoscopic donor nephrectomy

Abstract

Laparoscopic donor nephrectomy (LDN) is an established operation for organ procurement in living donor transplantation. Living donor renal transplantation is being performed more frequently and is associated with better graft function and survival. The minimal access approach for organ procurement from healthy individuals ensures early convalescence and improved patient participation. Here we describe a rare complication of LDN. Postoperative chylous ascites frequently occurs secondary to aortic surgery. Though previously described after LDN, its treatment remains contentious. Conventional strategies have adopted an expectant approach with medical management. These include parenteral feeding, bowel rest and somatostatin analogue usage. We report laparoscopic suture ligation as the principal management of postoperative chyle leak. We advocate surgical exploration in acute onset, high output chylous ascites. Pre-existing port site incisions were used for undertaking successful laparoscopic repair. This surgical approach enabled faster convalescence and reduced hospital stay—important considerations for our healthy living donor.


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