Octreotide as a new option for the management of chylous fistula after neck dissection
DOI:
https://doi.org/10.6016/ZdravVestn.3112Keywords:
chyle, thoracic duct, surgical complication, treatment, somatostatin analogueAbstract
One of the complications of neck dissection is chylous fistula. Usually, it is a consequence of a thoracic duct injury. A swelling forms in the lower neck area on the left side. Clear or milky-white fluid discharge can be seen. The colour of the fluid depends on the fat content. The goal of the treatment is closure of the fistula and a complete stop of the leak. Conservative methods consist of nutritional support, such as low-fat diet, diet with medium-chain triglycerides, fat-free diet, pressure dressings, and novel management with octreotide. It inhibits the production of chyle, thus enabling the fistula to heal.
Two patients with chylous fistula are reported, who were successfully treated with conventional conservative methods and octreotide. A literature review was conducted on the use of octreotide for the management of chylous fistula following neck dissection.
Octreotide in combination with conventional conservative methods successfully closes the majority of chylous fistulas on the neck without revision surgery.
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