@article{3126411,
    title = "Definition and classification of chyle leak after pancreatic operation: A consensus statement by the International Study Group on Pancreatic Surgery",
    author = "Besselink, M.G. and van Rijssen, L.B. and Bassi, C. and Dervenis, C. and Montorsi, M. and Adham, M. and Asbun, H.J. and Bockhorn, M. and Strobel, O. and Büchler, M.W. and Busch, O.R. and Charnley, R.M. and Conlon, K.C. and Fernández-Cruz, L. and Fingerhut, A. and Friess, H. and Izbicki, J.R. and Lillemoe, K.D. and Neoptolemos, J.P. and Sarr, M.G. and Shrikhande, S.V. and Sitarz, R. and Vollmer, C.M. and Yeo, C.J. and Hartwig, W. and Wolfgang, C.L. and Gouma, D.J. and for the International Study Group on Pancreatic Surgery",
    journal = "Otolaryngology - Head and Neck Surgery (United States)",
    year = "2017",
    volume = "161",
    number = "2",
    pages = "365-372",
    publisher = "Mosby Year Book Inc",
    doi = "10.1016/j.surg.2016.06.058",
    keywords = "triacylglycerol, Article;  chyle leak;  consensus;  disease classification;  disease severity;  drain;  human;  incidence;  outcome assessment;  pancreas surgery;  postoperative complication;  priority journal;  risk factor;  surgical wound;  adverse effects;  anastomosis;  Anastomotic Leak;  chylous ascites;  classification;  female;  international cooperation;  male;  pancreas resection;  Pancreatic Neoplasms;  Postoperative Complications;  procedures;  prognosis;  risk assessment;  severity of illness index;  treatment outcome, Anastomosis, Surgical;  Anastomotic Leak;  Chylous Ascites;  Consensus;  Female;  Humans;  Internationality;  Male;  Pancreatectomy;  Pancreatic Neoplasms;  Postoperative Complications;  Prognosis;  Risk Assessment;  Severity of Illness Index;  Treatment Outcome",
    abstract = "Background Recent literature suggests that chyle leak may complicate up to 10% of pancreatic resections. Treatment depends on its severity, which may include chylous ascites. No international consensus definition or grading system of chyle leak currently is available. Methods The International Study Group on Pancreatic Surgery, an international panel of pancreatic surgeons working in well-known, high-volume centers, reviewed the literature and worked together to establish a consensus on the definition and classification of chyle leak after pancreatic operation. Results Chyle leak was defined as output of milky-colored fluid from a drain, drain site, or wound on or after postoperative day 3, with a triglyceride content ≥110 mg/dL (≥1.2 mmol/L). Three different grades of severity were defined according to the management needed: grade A, no specific intervention other than oral dietary restrictions; grade B, prolongation of hospital stay, nasoenteral nutrition with dietary restriction, total parenteral nutrition, octreotide, maintenance of surgical drains, or placement of new percutaneous drains; and grade C, need for other more invasive in-hospital treatment, intensive care unit admission, or mortality. Conclusion This classification and grading system for chyle leak after pancreatic resection allows for comparison of outcomes between series. As with the other the International Study Group on Pancreatic Surgery consensus statements, this classification should facilitate communication and evaluation of different approaches to the prevention and treatment of this complication. © 2016 Elsevier Inc."
}