Changes over time in milk test results following pancreatectomy

Area of Science:

• Gastroenterology
• Surgical Oncology
• Abdominal Surgery

Background:

• Pancreatectomy is a complex surgical procedure with potential complications such as chylous ascites.
• The milk test is a diagnostic tool used to identify chyle leaks.
• Vessel sealing devices are increasingly utilized in pancreatic resections.

Purpose of the Study:

• To evaluate changes in milk test results over time after pancreatectomy.
• To assess the impact of vessel sealing technology on milk test outcomes.
• To determine the incidence of chylous ascites following pancreatectomy.

Main Methods:

• A retrospective analysis of 66 pancreatectomy cases from April 2008 to October 2013.
• Routine use of the milk test to detect chyle leaks.
• Comparison of positive milk test rates and drain volumes before and after the implementation of LigaSure™ (LS).

Main Results:

• The overall positive milk test rate was 13.6% (8 of 59 cases).
• Chylous ascites occurred in 1.7% of all pancreatectomy cases.
• Positive milk test rates decreased in distal pancreatectomy cases after using LS (33.3% to 0%), and drain volumes showed a trend towards reduction.

Conclusions:

• Positive milk test rates and chylous ascites incidence have decreased over time.
• The use of vessel sealing technology, such as LigaSure™, may play a significant role in preventing postoperative chylous ascites.