Intranodal lymphangiography combined thoracic duct embolization in the treatment of chylous leakage
10.3760/cma.j.cn112149-20200212-00142
- VernacularTitle:经淋巴结穿刺淋巴管造影并胸导管栓塞治疗乳糜漏
- Author:
Chao LIU
1
;
Pengxu DING
;
Rui YUAN
;
Ling WANG
;
Miao XU
;
Donglei LIU
;
Gaofeng ZHAO
;
Ying LIU
;
Zongming LI
;
Lei YAN
;
Xinwei HAN
Author Information
1. 郑州大学第一附属医院放射介入科 450052
- From:
Chinese Journal of Radiology
2020;54(11):1061-1065
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the safety and feasibility of intranodal lymphangiography combined thoracic duct embolization in the treatment of chylous leakage.Methods:The clinical data of ten patients with chylous leakage from July to December 2019 in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed. There were 6 cases of chylothorax, 1 case of chylous ascites, and 3 cases of chylothorax combined with chylous ascites, respectively. Conservative treatment was invalid in all cases. The locations of cisterna chyli and thoracic duct were defined by percutaneous puncture intranodal lymphangiography. Then the percutaneous transabdominal puncture of cisterna chyli was performed and the microcatheter was inducted. The location of fistula was visualized by thoracic duct lymphangiography, and the embolization was performed by microcoils combined tissue adhesive agents. The post-operative curative effect and complications were recorded.Results:One patient did not receive thoracic duct embolization because it was failed to visualize cisterna chyli by intranodal lymphatic angiography; thoracic duct embolization was successfully performed in the other 9 patients after chylous leakage fistula was located. Percutaneous transabdominal puncture of cisterna chyli was successfully accomplished in 8 patients. As for the other patient, after repeated failure of puncture, fluoroscopy-guided retrograde puncture at the proximal thoracic duct was performed successfully. After the operation, the drain output was completely disappeared within 3 to 7 days in 8 patients, and decreased down to 120 ml/d in 1 patient. Mild abdominal hemorrhage was found in 1 patient after thoracic duct embolization, without any treatment. No serious complications was found in all cases.Conclusion:Intranodal lymphangiography and thoracic catheter embolization is safe and effective in the treatment of chylous leakage, with a low complication rate.
