胃癌根治術後に発生した難治性肝リンパ漏の1例

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  • A CASE OF INTRACTABLE HEPATIC LYMPHORRHEA FOLLOWING RADICAL GASTRECTOMY FOR A GASTRIC CANCER

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A 44-year-old woman after radical gastrectomy for a gastric cancer developed intractable hepatic lymphorrhea. On 11th day after the gastrectomy, second operation for closing the lymphorrhea was tried, but no site of lymphorrhea could be identified. Massive ascites continued. Peritoneo-venous shunt operation was performed on 30th day after the first operation and the abdominal symptoms were alleviated.<br> Eight months later, the occlusion of the shunt tube caused the abdominal symptoms recurrently. So we tried to close the discrips lymphatics on the hepatoduodenal ligament with ligation, suture, and covering the part with free graft of peritoneum, that the patient was cured.<br> Because this patient had been suffering from chronic active hepatitis, it was suspected that the hepatic dysfunction prevented the healing of intractable hepatic lymphorrhea. And so, it is important to consider so as not to congest the current of the lymph and to ligate the lymphatics in dissection of hepatoduodenal ligament.

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