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We report a case of 46\u2010year\u2010old patient with chylous ascites after left laparoscopic adrenalectomy for metastatic lung cancer. The conservative treatments failed, included diet control, somatostatin provided and intranodal lymphangiography with lipiodol injection. Laparotomy was performed to explore the lymphatic vessel in the retroperitoneal area where a major and several small leaking holes were identified along the thoracic duct. The left gonadal vein was explored and transposed toward the lymphatic vessel. The lymphaticovenous anastomosis (LVA) was done using side (major leaking hole) to end (gonadal vein) fashion. The chylous leakage dropped from 2000 to 200\u2009mL per day gradually within 10\u2009days after LVA, and the patient was discharged uneventfully 30\u2009days after the LVA surgery. He was followed at our clinic during the first postoperative 10 months without recurrent chylous ascites. This case demonstrates that microsurgical intervention with LVA to physiologically drain the chyle can be an optimal treatment for chylous ascites. A literature review was also conducted, and strategic management is proposed.<\/jats:p>","DOI":"10.1002\/micr.30740","type":"journal-article","created":{"date-parts":[[2021,4,6]],"date-time":"2021-04-06T14:50:20Z","timestamp":1617720620000},"page":"480-487","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Management of intractable post\u2010adrenalectomy chylous ascites with microsurgical intra\u2010abdominal lymphaticovenous anastomosis: A case report and literature review"],"prefix":"10.1002","volume":"41","author":[{"given":"Cheng\u2010Feng","family":"Chu","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Chang Gung Memorial Hospital  Keelung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun\u2010Te","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Urology Chang Gung Memorial Hospital  Keelung Taiwan"},{"name":"College 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