Management of chylous ascites following laparoscopic presacral neurectomy

Fang Ping Chen*, Tsia Shu Lo, Yung Kuei Soong

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

24 Scopus citations


Chylous ascites is an extremely rare complication of laparoscopic presacral neurectomy (LPSN), and treatment is still controversial. Four patients undergoing LPSN for dysmenorrhoea or chronic pelvic pain were complicated with chylous ascites. Two were successfully treated with bipolar cauterization and one, after the failure of initial treatment by bipolar cauterization, was then effectively managed by compression with Gelform and closure of the peritoneum of the presacral area by suture through laparoscopy. The fourth patient had persistent chyle leakage from the drainage tube after electrocauterization and was finally cured by conservative management including removal of the drainage tube and a low-fat diet for 3 weeks. Chylous ascites has not been reported in laparoscopic presacral neurectomy. Management that is quick, effective and subjects the patients to the least amount of suffering is still unresolved. Repeated laparoscopy can be considered to identify the possibility of injury to lymphatic vessels, to relieve abdominal distention due to chyle accumulation, and to apply electrocauterization or compression with Gelform and closure of the peritoneum. Conservative treatment with a low-fat diet may need a longer time. The use of a drainage tube may provide negative pressure allowing a continuous leakage of chyle. However, more controlled study is required to identify the most proper and effective management.

Original languageEnglish
Pages (from-to)880-883
Number of pages4
JournalHuman Reproduction
Issue number4
StatePublished - 1998


  • Chylous ascites
  • Dysmenorrhoea
  • Electrocauterization
  • Laparoscopic presacral neurectomy
  • Low-fat diet


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