<div>Key points:</div><ul><li>Chyle leaks (CLs) following neck dissection for metastatic head and
neck malignancy are infrequent but represent a serious complication,
with an incidence of 1-2.5%.</li><li>CL is associated with significant morbidity including metabolic
imbalance, immunosuppression, dehydration, poor wound healing and
prolonged length of hospital stay.</li><li>A protocolised approach to the management of CL post neck dissections
is highlighted for expedient patient management.</li><li>Thoracic duct (TD) ligation using video-assisted thoracoscopic surgery
(VATS) is an effective method of treating moderate (500-1000ml/24
hours) to high-volume CL (&gt;1000ml/24 hours) not
responding to medical therapy.</li><li>VATS TD ligation is a safe procedure to treat CL. It has a low
morbidity compared to other surgical techniques (neck re-exploration
or open thoracotomy).</li></ul>