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Nutritional Management in Patients with Chyle Leak following Head and Neck Surgery: A Systematic Review

Published online by Cambridge University Press:  18 December 2025

Nimeshi Jayakody Open the ORCID record for Nimeshi Jayakody [Opens in a new window] ,
Phillip Brown ,
Callum Findlay  and
Nimesh N Patel
Nimeshi Jayakody*
Affiliation:
ENT department, University Hospital Southampton NHS Foundation Trust, Southampton, UK
Phillip Brown
Affiliation:
ENT department, University Hospital Southampton NHS Foundation Trust, Southampton, UK
Callum Findlay
Affiliation:
ENT department, University Hospital Southampton NHS Foundation Trust, Southampton, UK
Nimesh N Patel
Affiliation:
ENT department, University Hospital Southampton NHS Foundation Trust, Southampton, UK
*
Corresponding Author: Nimeshi Jayakody; Email: nimeshi01@hotmail.co.uk
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Abstract

Objective

We aim to investigate nutritional management of chyle leaks by a systematic review of the published literature.

Methods

We searched the following databases (Medline, Embase, Cochrane) for literature incorporating nutritional aspects in chyle leak management. We excluded non-English papers, paediatric studies, conference papers, and studies without nutritional intervention.

Results

Among 260 patients (out of 26,270), 81.5.% (n=212/260) achieved chyle leak resolution with nutritional management, while 18.5% (n=48/260) required surgery. Median resolution duration with nutritional management was 8.7 days (range: 4.3 to 22.2), compared to surgical treatment’s median of 32 days (range: 18 to 40).

Conclusion

We recommend use of nutritional management in all patients with chyle leaks. There is no evidence supporting one diet over the other however clinically we suggest starting with medium–chain triglyceride/non–/low–fat diets and moving onto total parenteral nutrition, unless medically indicated otherwise.

Keywords

ChyleNeck DissectionFatty Acids, Medium-ChainTotal Parenteral NutritionEnteral NutritionDiet, fat restricted

Information

Type
Review Article
Information
The Journal of Laryngology & Otology , First View , pp. 1 - 10
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.

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