# Comprehensive Analysis of Chyle Leak in Resected Pancreatic Head Cancer: Impact on Clinical, Oncologic, and Nutritional Outcomes

## TL;DR

The study finds that chyle leak after pancreatic surgery prolongs hospital stays and worsens nutritional outcomes but does not affect long-term cancer outcomes.

## Contribution

The study clarifies the clinical and nutritional impact of chyle leak using a standardized definition, resolving prior inconsistencies.

## Key findings

- Chyle leak was associated with prolonged hospital stays and poor nutritional status at discharge.
- Chyle leak did not significantly affect oncologic outcomes like survival or recurrence.
- Hypertension, lymph node metastasis, and minimally invasive surgery were independent predictors of chyle leak.

## Abstract

Chyle leak (CL) is a relevant complication of pancreatic surgery, but its incidence, risk factors, clinical and oncologic impacts, and nutritional relevance remain inconsistent and limited.

We retrospectively reviewed patients who underwent pancreaticoduodenectomy for pancreatic head cancer from 2007 to 2023 at a single institution. The clinical impact of CL was evaluated by prolonged hospital stays and immune‐nutritional status, assessed using the Controlling Nutritional Status (CONUT) score at discharge. Oncologic impact included the administration of adjuvant chemotherapy, the surgery‐to‐chemotherapy interval, overall survival (OS), and recurrence‐free survival (RFS). Predictors of CL were identified through multivariate analyses.

CL occurred in 70 patients (13.8%) and was significantly associated with prolonged hospital stay (OR: 1.947, p = 0.045) and poor CONUT score at discharge (> 6; OR: 1.820, p = 0.036). CL did not significantly impact oncologic outcomes, including adjuvant chemotherapy (p = 0.732), surgery‐to‐chemotherapy interval (p = 0.235), 5‐year OS (p = 0.978), or 5‐year RFS (p = 0.919). Independent predictors of CL included hypertension, lymph node metastasis, delayed gastric emptying, minimally invasive surgery (MIS), and operative time.

CL is associated with prolonged hospital stay and poor nutritional status at discharge, but shows no significant impact on long‐term oncologic outcomes.

Kwak and colleagues conducted a comprehensive analysis of chyle leak in resected pancreatic head cancer using the standardized 2017 ISGPS definition. They confirmed its association with prolonged hospital stay and impaired nutritional status but found no significant oncologic relevance, clarifying previously inconsistent findings due to the lack of a standardized definition.