목적: Chyle fistula is relatively rare complications of neck dissection (ND), whose incidence, risk factors, and management still lacks clear consensus. We have reviewed our 8-year experience with chyle fistula after neck dissection in a single center. 방법:Between 2007 and 2014, 472 cases of ND involving level IV compartment were included in the study from 408 patients and their medical records were reviewed. Incidence, risk factors, and clinical course of chyle fistula were investigated. Regarding management of chyle fistula, effect of octreotide (long-acting somatostatin analogue) as a medical treatment was assessed through the subgroup analysis. 결과:Overall incidence of chyle fistula was 4.7% (22/472). Although those were not statistically significant, left-sided ND and history of previous irradiation showed trends toward higher incidence of chyle fistula.In 22 cases with chyle fistula, mean total drainage amount was 3226 mL during mean 15.4 days of drain placement. Seven (31.8%) cases of chyle fistulae were early onset and 6 (27.3%) were high output. Nine (40.9%) out of 22 cases experienced complications associated with chyle fistula, such as chylothorax and electrolyte imbalance. Eighteen (81.8%) cases were successfully treated with non-surgical modalities while 4 (18.2%) cases required open surgical interventions, which were all left neck cases. In 6 high output cases, 4 were initially managed with conservative methods including octreotide injection and 3 of them did not require surgery. 결론:Incidence of chyle fistula after ND is higher than expected. It causes loss of extremely large amount of body fluid and prolonged duration of placement with high incidence of associated complications. Although additional benefits of octreotide to traditional conservative methods cannot be determined through the present study alone, it may be used as another option of conservative treatment before the surgical intervention.