{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T12:25:02Z","timestamp":1780316702261,"version":"3.54.1"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,2,7]],"date-time":"2013-02-07T00:00:00Z","timestamp":1360195200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2013,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Chyle leakage is a rare complication of pancreaticoduodenectomy (PD), and its association with pancreatic fistula has not been established. The aim of this study was to (1) evaluate the incidence, management, and risk factors of chyle leakage after PD; (2) determine if there is a relation between chyle leakage and diagnosis of pancreatic fistula; and (3) predict chyle leakage with drainage volume early.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 222 patients underwent PD or pylorus\u2010preserving PD. We used the clinical database registry system of the Gangnam Severance Hospital, Yonsei University Health System to establish a retrospective cohort with clinicopathologic data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Altogether, 24 patients (10.8 %) developed chyle leakage. Chyle leakage was identified at a median 5\u00a0days after surgery and a mean 2\u00a0days after enteral intake. The mean drain triglyceride level was 315\u00a0mg\/dl. Early enteral intake was independently associated with chyle leakage. Chyle leakage was inversely correlated with a diagnosis of pancreatic fistula with marginal significance (odds ratio 0.27; 95 % confidence interval 0.66\u20131.09). The receiver operating characteristic curve of the volume on postoperative day 4 demonstrated an area under the curve of 0.740 (<jats:italic>p<\/jats:italic> = 0.0001). Drainage &gt;335\u00a0ml indicated possible chyle leakage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Chyle leakage after PD is associated with early enteral intake. It was inversely correlated with a diagnosis of pancreatic fistula because of the dilution effect of drainage volume on the concentration of drained amylase. Because early diagnosis helps with appropriate management, prediction\/suspicion of chyle leakage based on drainage volume may be useful.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-013-1919-7","type":"journal-article","created":{"date-parts":[[2013,2,6]],"date-time":"2013-02-06T18:29:58Z","timestamp":1360175398000},"page":"854-862","source":"Crossref","is-referenced-by-count":18,"title":["Drainage Volume After Pancreaticoduodenectomy Is a Warning Sign of Chyle Leakage That Inversely Correlates With a Diagnosis of Pancreatic Fistula"],"prefix":"10.1002","volume":"37","author":[{"given":"Jae Keun","family":"Kim","sequence":"first","affiliation":[{"name":"Pancreatobiliary Cancer Clinic, Department of Surgery, Gangnam Severance Hospital Yonsei University College of Medicine 211 Eunjoro Gangnam\u2010gu 135\u2010720 Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joon Seong","family":"Park","sequence":"additional","affiliation":[{"name":"Pancreatobiliary Cancer Clinic, Department of Surgery, Gangnam Severance Hospital Yonsei University College of Medicine 211 Eunjoro Gangnam\u2010gu 135\u2010720 Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ho Kyoung","family":"Hwang","sequence":"additional","affiliation":[{"name":"Division of Hepatobiliary and Pancreas, Department of Surgery Yonsei University College of Medicine Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun Wook","family":"Shin","sequence":"additional","affiliation":[{"name":"Pancreatobiliary Cancer Clinic, Department of Surgery, Gangnam Severance Hospital Yonsei University College of Medicine 211 Eunjoro Gangnam\u2010gu 135\u2010720 Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong Sup","family":"Yoon","sequence":"additional","affiliation":[{"name":"Pancreatobiliary Cancer Clinic, Department of Surgery, Gangnam Severance Hospital Yonsei University College of Medicine 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