Diagnosis and Treatment of Postoperative Chyle Leakage via Percutaneous Transabdominal Catheterization of the Cisterna Chyli: A Preliminary Study

摘要: Purpose To assess the feasibility of percutaneous transabdominal puncture and catheterization cisterna chyli or lymphatic ducts (PTCLD) in patients with postoperative chyloperitoneum chylothorax, to identify possibly embolize chylous fistula. Materials Methods Five had uncontrolled chyle fistulas. Two chylothorax thoracic duct (TD) ligation after esophagectomy neck surgery. The other three ascites surgery pancreas, aorta, esophagus, respectively. After lympho-graphic opacification, (CC) retroperitoneal lymph were punctured transabdominally a 21-gauge needle catheterized 3-F catheter reach TD if possible. Microcoils used laceration. Results Lymph as small 2–3 mm successfully patients. was two patients; one fistula embolized cure chylothorax. In patient surgically tied TD, occlusion confirmed despite continued pleural effusion. Three fistulas, not seen lymphography, identified There no morbidity. As result this procedure, four five did require repeated operation. Conclusions PTCLD study fistulas feasible safe management clinically useful lymphography aqueous contrast medium is more sensitive than pedal lymphography. Further evaluation necessary.