Abstract:

BACKGROUND: Lymphatic fistula is rare complication following liver transplantation. However, portal hypertension can result in obstruction of lymph circumfluence. Thus, damage to lymphatic vessel should be prevented during transplantation.
OBJECTIVE: To review the experience for lymphatic fistula after liver transplantation.
METHODS: Three cases of lymphatic fistula after liver transplantation were retrospective analyzed. One case was diagnosed with hepatitis C cirrhosis, 2 cases with liver cancer combined with liver cirrhosis preoperatively. All cases were performed orthotopic liver transplantation. The diagnosis and treatment of 3 patients were recorded.
RESULTS AND CONCLUSION: Normal diet were given to 3 patients at 6-8 days after liver transplantation, the right hepatic drainage from liver graft were suddenly increased, as milk white, which got clear again after low-protein diet. No abdominal pain, abdominal distension and fever were observed. Drainage fluid of 3 patients were positive for Sudan Ⅲ staining, and levels of triglyceride and total cholesterol in drainage fluid was similar to that in serum. Ultrasound showed seroperitoneum. Patients with lymphatic fistula after liver transplantation should be fasting firstly, and then given low-fat diet and parenteral nutrition for conservative treatment, thus, healing could be achieved after 1 week. The dissociation during liver transplantation should be ligated to prevent lymphatic fistula. Postoperative lymphatic fistula should be controlled by fasting and parenteral nutrition.