ObjectiveTo review the advances in the pathogenesis, diagnostic modalities, treatment strategies, and preventive measures of chyle leak following gastric cancer surgery, aiming to provide an evidence-based reference for clinical practice. MethodsRecent domestic and international studies concerning the risk factors and management of postoperative chyle leak in gastric cancer were retrieved and systematically analyzed. ResultsPostoperative chyle leak is primarily caused by extensive lymphadenectomy. Advanced age, obesity, and extended lymph node dissection are identified as high-risk factors. The diagnosis can be confirmed by analyzing the characteristics and triglyceride concentration of the drainage fluid, while imaging techniques facilitate the precise localization of the leak. The majority of patients can be cured with conservative management, encompassing fasting, a medium-chain triglyceride diet, and somatostatin therapy. For high-output or refractory cases, interventional radiology or surgical treatments are indicated. ConclusionsThe management of post-gastrectomy chyle leak should adhere to the comprehensive principles of “perioperative prevention, early recognition, and standardized intervention”. Future multicenter randomized controlled trials and the development of risk prediction models are warranted to provide high-level evidence for individualized clinical decision-making and further improve patients’ outcomes.
