In the present case, the patient developed pancreatic ascites likely due to trauma to the pancreatic duct during laparoscopic cholecystectomy. We propose a potential relationship between acute biliary pancreatitis and the development of chylous ascites. Context Chylous ascites a rare complication post cholecystectomy. Read the Clinical Chemistry Journal's July 2017 Clinical Case Study and student discussion. We describe a case of chylous ascites post open cholecystectomy in a patient with recent severe pancreatitis. It has never been reported after laparoscopic cholecystectomy. We describe a 31-year-old female who presented 2 weeks postoperatively after laparoscopic cholecystectomy with abdominal distention and pain. Spontaneous chylous ascites after laparoscopic cholecystectomy: a case report Arpit Bansal1, Ashwani Kumar Bansal1*, Vandana Bansal2, Mamta Singh3 Dr. INTRODUCTION Chylous ascitis refers to collection of milky creamy fluid rich in triglyceride content above200 mg/dL and rich in small lymphocytes in peritoneal cavity.1,2 The differential diagnosis included pancreatic ascites, chylous ascites, and a bile leak. Pancreatic Ascites Amylase concentration in ascites several fold greater than serum was consistent with a pancreatic leak. Chylous ascites is a rare complication after many abdominal procedures. It has never been reported after laparoscopic cholecystectomy. These collections typically occur in the right or the left supramesocolic spaces. 6 It was suggested to occur as a result of peritoneal irritation caused by spillage of endometriotic cyst contents. Surgeons must watch for the clinical manifestations of bile ascites after laparoscopic cholecystectomy. Patients with ascites underwent cholecystectomy less often than patients without ascites (21% vs 39%; P = .002). Bile Ascites . Bile ascites can develop after trauma, cholecystectomy, biliary tract surgery, hepatic surgery, liver biopsy, and percutaneous biliary drainage. Persistence of symptoms following cholecystectomy continues to be studied extensively. Presences of long cystic duct remnant, stone in remnant cystic duct, incomplete or subtotal cholecystectomy were blamed. We describe the diagnosis and management of chylous ascites post cholecystectomy. Chylous ascites is a rare complication after many abdominal procedures. We describe a 31-year-old female who presented 2 weeks postoperatively after laparoscopic cholecystectomy with abdominal distention and pain. postoperative chylous ascites, or retroperitoneal lymph node dissection where there is significant injury to the cisterna chyli [5, 6]. Post Cholecystectomy Syndrome. This diagnosis should be suspected whenever persistent bloating and anorexia last for more than a few days; failure to recover as smoothly as expected is the most common early symptom of bile ascites. A 32-year-old man presented with severe abdominal pain and ascites. In cholecystectomy it is uncertain what degree of injury has occurred for the development of chylous ascites. Rationale: Gallstone disease is commonly worldwide and safely treated by laparoscopic cholecystectomy.Chylous ascites is a rare but serious complication of many abdominal operations. His medical history included diagnosis of Sandifer syndrome, scoliosis requiring 3 spinal surgeries, microgastria, and hiatal hernia repair, and most recently, laparoscopic cholecystectomy (7 weeks prior). Cholecystectomy results in loss of the absorptive and pressure-regulating function of the gallbladder and the fasting reservoir where bile is concentrated. 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