High-Dose Intravenous Octreotide Is Safe and May Be Superior to Surgery in Managing Severe Postesophagectomy Chylothorax in High-Risk Patients.

Abstract

Postesophagectomy chylothorax is a relatively rare but potentially lethal complication. Management can be challenging, especially of patients after radiotherapy. Chest tube drainage, bowel rest, total parenteral nutrition, and adequate fluid replacement are the preferred first-line treatment. Thoracic duct band ligation is the approach of last resort; however, surgical reexploration is often not an option in these patients. The use of octreotide to control chylothorax in adults has been reported, but mainly when given in low subcutaneous doses. We report the successful use of high intravenous doses of octreotide to manage large postesophagectomy chylothorax in an adult after failed band ligation.