Diet group will be on no-fat diet including MCT-oil supplement starting right after surgery according to our pancreas ERAS-protocol.

This study group will follow normal ERAS-protocol after pancreas surgery and start normal diet after surgery. If chyle-leak is diagnosed then it will be treated with the same no-fat diet as the intervention group.

Lymph Leakage

Chyle Into Mesentery; Extravasation

Pancreatic Cancer

Complication of Surgical Procedure

In the diet, there is no long-chain triglycerides. Fat and protein needs are met with adding medium-chain-fat acid as oil and protein supplements to the diet. Diet has been constructed together with clinical nutrition specialist.

Diet group

Helsinki university hospital

Prevention of Chyle-leak After Major Pancreatic Surgery

Post-operative chyle leak is diagnosed if drain fluids triglyserid content is above normal at post-operative day 3 (> 1,5mmol/l).

Tiina Vuorela

MD, PHd student, Junior surgeon

Helsinki University Central Hospital

Patients who fill our study ciriteria are asked to join in on the study and then they are randomized in to two groups, interventional and control group

Dietary treatment with medium-chain triglyceride diet (MCT-diet) until resolution of CL.

Postoperative Chyle Leak

Removal of surgical drains despite persistent CL, without dietary restrictions or dietary treatment for CL.

Standard care irrespective of CL

Dietary treatment with MCT-diet until resolution of CL.

Dietary treatment (MCT-diet)

Ludwig-Maximilians-University

Chyle Leak After Pancreatic Surgery

Chyle Leak After Pancreatic Surgery - CLAP

Complications ≥ Clavien-Dindo3 grade IIIa

The time spent at the hospital will be recorded

The time until drain removal will be recorded

Patients will be called and asked for any readmission to a hospital (yes /no)

Weight (Day before surgery) - Weight (10 days postoperatively)

BMI (day before surgery) - BMI (10 days postoperatively)

INR (Day before surgery) - INR (10 days postoperatively)

Albumin level (Day before surgery) - Albumin level (10 days postoperatively)

Cortisol levels will be compared between group A and B

Patient satisfaction will be measured using a standardized questionnaire

Jan D'Haese

Associate professor, principal investigator

Ludwig-Maximilians - University of Munich

Chylothorax

Target Fortification

Higher Initial Concentration

Portagen Formula

The Hospital for Sick Children

Optimizing Growth in Infants Receiving Modified Fat Breast Milk for the Treatment of Chylothorax

Optimizing Growth in Infants Receiving Modified Fat Breast Milk for the Treatment of Chylothorax Following Cardiothoracic Surgery

Deborah O'Connor

Senior Associate Scientist, Physiology and Experimental Medicine

Labatt Family Heart Centre

Canadian Institutes of Health Research (CIHR)

Infants in this arm of the study were fed their own mother's breast milk where the fat layer was removed by centrifugation. Prior to feeding, extra energy and nutrients were added to the defatted breast milk.

Infants in this arm of the study were fed a MCT-containing medical food which is the current standard of care.

Fat-Modified Breast Milk

MCT formula

Dietary Treatment of Infants With Chylothorax

The Effectiveness of Low Fat Breast Milk for the Treatment of Chylothorax in Infants Following Cardiothoracic Surgery: A Pilot Study

This outcome includes measurement of chyle drainage from chest tubes in the first 5 days after diagnosis of chylothorax and the number of days of chest tube drainage.

Infant weight, length and head circumference measurements were determined at study initiation and at the first post-discharge follow-up visit (within one-week of discharge) and again at the end of chylothorax treatment.

Average daily energy, protein and other nutrient intakes were calculated using milk volumes consumed (recorded in the medical record [in-hospital] or 3 day consecutive food records [after discharge]), analyzed breast milk fat composition values, milk nutrient values from the literature, product monographs and Food Processor SQL Ed v. 10.2 (ESHA Research).

Senior Associate Scientist

Trainee award through Ontario Student Opportunity Trust Fund - The Hospital for Sick Children Foundation Scholarship

INTRAMUSCULAR INJECTION OF PASIREOTIDE 60 MG

Breast Cancer

One INTRAMUSCULAR INECTION OF PASIREOTIDE 60 MG 10 TO 7 DAYS BEFORE SURGERY

PASIREOTIDE

ONE INJECTION OF PLACEBO 10 TO 7 DAYS BEFORE SURGERY

PLACEBO

Tenon Hospital

Institut Gustave ROUSSY

Pasireotide LAR Administration in Lymphocele Prevention After Axillary Node Dissection for Breast Cancer

Evaluation of the Effect of Pasireotide LAR Administration in the Lymphocele Prevention After Axillary Node Dissection for Breast Cancer

the patients ratio who did not have post-operative axillary symptomatic lymphoceles defined as the absence of aspiration or a unique or iterative aspirations global volume of lymphoceles inferior to 60cc inclusive (≤) in the 28 days after the intervention or a systematic aspiration volume at the 28th day inferior to 120cc inclusive (≤).

chylothorax/triglyceride

Prevention of Chyle-leak After Major Pancreatic Surgery

Chyle Leak After Pancreatic Surgery

Optimizing Growth in Infants Receiving Modified Fat Breast Milk for the Treatment of Chylothorax

Dietary Treatment of Infants With Chylothorax

Pasireotide LAR Administration in Lymphocele Prevention After Axillary Node Dissection for Breast Cancer

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