A Case of Chyluria after Surgery for Gallbladder Cancer

Ryota Higuchi, Takehiro Ota, Nobuhiro Takeshita, Hideki Kajiyama, Takehisa Yazawa, Kenichiro Onuki, Yohsuke Yagawa, Mie Hamano*, Tatsuo Araida* and Masakazu Yamamoto

Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University
Department of Surgery, Tokyo Women's Medical University Yachiyo Medical Center*

We report a very rare case of chyrulia following biliary and abdominal surgery. A 58-year-old woman undergoing right lobectomy with bile duct and portal vein resection and reconstruction after percutaneous transhepatic portal vein emborization for gallbladder cancer with infiltration to the right hepatic artery, portal vein and bile duct was discharged on postoperative day (POD) 26 without major complication so she was readmitted for dehydration, electrolyte imbalance, and chyrulia on POD 50, discharged again after symptomatic therapy, then readmitted for shortness of breath and appetite loss. Left pelvic kidney urine was normal, but right pelvic kidney urine included 2+proteinuria/2+sugar in split renal function, spouting of chyrulia from the right ureter closest at cystoscopy. Filarial antibody was negative. Based on a diagnosis of chyrulia due to lymphorrea at the right pelvis due to gallbladder cancer surgery influence, she underwent unilateral stripping of the right renal pedicle. Postoperatively, hyponatremia, proteinuria, and urine dullness disappeared and ascites and edema were relieved. To the best of our knowledge, only one such case have been reported in the Japanese and English literature.

Key words
chyluria, biliary cancer, hepatectomy

Reprint requests
Ryota Higuchi Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University
8-1 Kawada-cho, Shinjuku-ku, 162-8666 JAPAN

Accepted
February 17, 2010

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