Massive lymphatic fluid leakage during laparoscopic lymphnode biopsy for abdominal malignancy

This report concerns massive lymphatic fluid leakage during laparoscopic abdominal lymphnode biopsy for mesenteric tumor of non-Hodgkin's disease. Laparoscopic lymphnode biopsy was performed on a 58-year-old man who presented with a huge abdominal mass. The initial diagnosis was based on abdominal computed tomography, which revealed a large mass. This was followed by laparoscopic abdominal lymphnode biopsy for a definitive diagnosis. During the operation, massive lymphatic leakage up to about 300 mL occurred, but was stopped completely by electric coagulation. Histological examination indicated the mass to be a B-cell type non-Hodgkin's lymphoma. Hospitalization was uneventful, and the patient was discharged 7 days postoperatively to the Department of Internal Medicine for chemotherapy. This new endoscopic approach offers a useful alternative to the traditional transabdominal excision of intra-abdominal lymphnodes, although attention must be paid to possible complications including massive intraoperative lymphatic leakage.