Lymphangiography in the Diagnosis and Localization of Various Chyle Leaks

Treatment options for chylous ascites after major abdominal surgery: a systematic review

“…In this study with overall 47 patients with chylous fistula, patients with contained chyle leaks represented the majority (n=34, 72.9%). These required total parenteral nutrition less frequently (44.1% vs. 92.3%), and had a shorter time to resolution (13 vs. 36 days) than those with diffuse chylous ascites (n=13)(15).The therapeutic use of bipedal lymphangiography with lipiodol has been described with occlusion rates from 35% to 70% (30,31,33) in patients with chylous ascites refractory to conservative treatment. A study by Alejandre-Lafont et al (n=43) demonstrated occlusion rates of 70% when the daily volume of chyle leakage was less than 500 ml (30).…”

Percutaneous Treatment of Chylous Ascites

“…11 The pain is usually transient and resolves over a few hours of observation or conservative management. The amount of drainage is monitored and documented to determine the outcome of the procedure.…”

“…28 The maximum dose of Lipiodol should not exceed 20 mL owing to risk of pulmonary embolism. 11 Fluoroscopy is used intermittently to avoid excessive radiation to the patient and operator. Lipiodol injection is continued until the Lipiodol reaches the ascending lumbar trunk.…”

“…2,9 In contrast, lymphangiography and percutaneous embolization is less invasive. [11][12][13] Lymphangiography alone has been reported to have therapeutic effect in 56%-86% of patients with lymphatic leaks. [13][14][15][16][17] Lymphatic embolization was first described by Cope et al where the thoracic duct was catheterized and subsequently embolized to treat chylothorax.…”

Direct lymphangiography as treatment option of lymphatic leakage: Indications, outcomes and role in patient's management

“…Directly lymphography can visualize and prove the lymphatic origin of a detected fluid collection as seen in chylaskos, lymphocele, chylothorax or lymphatic fistula in the postoperative or posttraumatic patient [1,2]. With the help of diagnostic lymphography, allocation of lymphatic fistula is possible because the lymphatic vessels are difficult to visualize intraoperatively due to the small size and the perioperative sobriety [3].…”