Chylous leakage after donor nephrectomy: a rare complication and a nightmare for surgeons

ABSTRACT

To evaluate chylous drainage and its management in donor nephrectomy patients. Retrospective study. Institute of Post Graduate Medical Education and Research [IPGME and R], Kolkata, and Medica Superspeciality Hospital, Kolkata, Kolkata, India. Donor nephrectomy patients [open or laparoscopy procedure]. The first case of chylous drainage which occurred after open donor nephrectomy was treated with conservative management for a prolonged period after browsing through literature. Later three cases which occurred after laparoscopic donor nephrectomy, were also managed conservatively. Incidence and management of chylous ascites or drainage after open or laparoscopic donor nephrectomy. In our institute, only four donor nephrectomy patients developed chylous drainage. Three were laparoscopic surgeries using the transperitoneal approach whereas one case was done using open retroperitoneal approach. Chylous drainage and its management are discussed. Overall, our cases showed that chylous drainage can develop in laparoscopic transperitoneal procedures as well as in open retroperitoneal surgery, and that surgical dissection in the retroperitoneal area or the renal hilum is the most important risk factor for this complication. All our cases were well-treated only by conservative management and it has proven to be the main first line management for this condition