A Case of Intractable Hepatic Lymphorrhea after Gastrectomy for Gastric Cancer

Yohichi Kawahira, Kazuyasu Nakao, Masaaki Nakahara, Masayasu Hamaji, Nobuo Ogino, Satoru Miyazaki

Department of Surgery, Osaka Police Hospital

The case of a 58-year-old woman with intractable hepatic lymphorrhea is reported. She had received distal gastrectomy for gastric cancer (pT₂N₀M₀) as well as liver biopsy, which showed non-active chronic hepatitis. She was readmitted with progressive retention of ascites on the 30th postoperative day. Diuretics and repeated reinfusion of ascites yielded disappointing results. Although peritoneovenous shunt was attempted, the shunt tube was obstructed with thrombus. Finally, laparotomy was performed to control the ascites. During the operation, hepatic lymphorrhea was oozing from the hepatic hilus, but we could not localize the oozing point. Therefore, we electrocauterized the hepatic hilus and layered fibrin glue to stop the lymphorrhea. Ascitic fluid retention disappeared within a few days after the operation. The postoperative course was uneventful, and she has shown no sign of recurrence of lymphorrhea or gastric cancer for more than 2 years after the first surgery.

Key words
surgery for intractable ascites, gastrectomy, postoperative hepatic lymphorrhea

Reprint requests
Masaaki Nakahara Department of surgery, Osaka Police Hospital
10-31 Kitayamacho, Tennojiku, Osaka, 543 JAPAN

Accepted
October 13, 1993

To read the PDF file you will need Abobe Reader installed on your computer.