[Surgical treatment of chyloperitoneum]

The investigation is based on 260 observations of patients with ascitis. According to the character of ascitis the patients were distributed as follows: chyloperitoneum--in 19 patients, serous ascitis--in 210, lymphatic--in 4, ascitis-peritonitis--in 27 patients. Milky colour of the liquid, content of chylomicrons more than 13.5%, triglycerides more that 2.5 mmol/l and lymphocytes more than 78% of the total number of the cells are considered the diagnostic signs of chyloperitoneum. The causes of chyloperitoneum might be the formation of an intraperitoneal lymphatic fistula against the background of congenital defects of the lymphatic system, rupture of the lymphatic cyst, as well as an infectious and inflammatory process in lymph nodes, vessels. Favorable surgical treatment of chyloperitoneum depends on timely diagnosing and detection of the source of its formation. Surgical strategy of treatment of chyloperitoneum patients must be selective and consider the leading pathogenetic factors and the severity of the patient's state. Most effective measures are suturing the lymphatic fistula, lymphatic cyst excision, elimination of lymphatic and portal hypertension, correction of the albuminous composition of blood.