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Lymphatic interventions for isolated, iatrogenic chylous ascites: A multi-institution experience
- Source :
- European journal of radiology. 109
- Publication Year :
- 2018
-
Abstract
- Objectives Lymphangiography and thoracic duct embolization are established treatments for post-surgical chylothorax. There is only limited experience in their application to treat post-surgical chylous ascites. A multi-center analysis of the technical and clinical success of lymphangiography and lymphatic interventions in the treatment of isolated, iatrogenic chylous ascites is reported. Methods 21 patients (14 males; 7 females) aged 3–84 years (mean 56.9 years; median 63 years) were treated for isolated, iatrogenic chylous ascites between August 2012 and January 2018. Initial referrals occurred between 5–330 days (mean 72.7 days; median 40 days) after failing conservative therapy. Daily leak volumes ranged from 100 to 3000 mL. Lymphangiographic findings, techniques, clinical outcomes, and complications were recorded. Results 21 patients underwent 29 procedures. Seven patients underwent multiple procedures after chylous ascites persisted. Bilateral nodal lymphangiography (NL) was technically successful in all (100%) patients. Lymphangiography identified a leak in 14/21 (67%) patients and in 16/29 procedures (55%). Ten procedures (34%) consisted of NL alone and one (3.4%) consisted of NL combined with lymphatic disruption (LD). Six procedures (21%) consisted of nodal glue embolization (NGE) while nine procedures (31%) were catheter-based lymphatic embolization. Three separate patients underwent three procedures (10%) consisting of balloon-occluded retrograde abdominal lymphatic embolization. Clinical success, defined as no additional drainage of chylous ascites at 15 days, was ultimately achieved in 18/21 patients (86%). There were no major or minor complications. Conclusion Lymphatic interventions can successfully treat post-surgical chylous ascites. Given the low risk of procedural complication, early intervention is encouraged.
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
medicine.medical_treatment
Iatrogenic Disease
Thoracic duct
030218 nuclear medicine & medical imaging
03 medical and health sciences
Young Adult
0302 clinical medicine
Chylous ascites
medicine
Humans
Radiology, Nuclear Medicine and imaging
Embolization
Glue embolization
Child
Chylous Ascites
Aged
Aged, 80 and over
business.industry
Chylothorax
Lymphography
General Medicine
Middle Aged
medicine.disease
Procedural complication
Embolization, Therapeutic
Surgery
Catheter
medicine.anatomical_structure
Lymphatic system
Treatment Outcome
030220 oncology & carcinogenesis
Child, Preschool
Female
business
Subjects
Details
- ISSN :
- 18727727
- Volume :
- 109
- Database :
- OpenAIRE
- Journal :
- European journal of radiology
- Accession number :
- edsair.doi.dedup.....6b0e51b5ae9c62846ae39abffcc3b488