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胃癌根治术并发乳糜胸腹水是罕见并发症,此并发症是由于术中误伤或操作不当使淋巴管破裂,损伤部位有:(1)损伤乳糜池或胸导管;(2)损伤肠淋巴干;(3)部分淋巴结或淋巴管未结扎而致手术后破裂。诊断的唯一方法是胸腹腔穿刺,如抽出乳白色液体,乳糜定性试验阳性则可确诊。术中熟悉淋巴系统解剖,尽可能避免损伤,在清扫淋巴结时应不厌其烦逐一结扎,术后仔细观察腹腔引流管,可得到早期诊断及时治疗。
Radical cystectomy and ascites is a rare complication of gastrectomy for gastric cancer. This complication is caused by accidental misoperation or improper operation to make the lymphatic vessel rupture. The injury site includes: (1) damage to the chyle duct or thoracic duct; (2) damage to the intestinal lymphoid stem; (3) Some of the lymph nodes or lymph vessels are not ligated and cause rupture after surgery. The only method of diagnosis is thoracic and abdominal cavity puncture, such as the extraction of milky white liquid, positive breast milk qualitative test can be confirmed. Intraoperative familiar with the lymphatic system anatomy, to avoid injury as much as possible, in the lymph node dissection should be taken one by one ligation, after careful observation of abdominal drainage tube, can be diagnosed and treated in time.