INTERVENTIONAL RADIOLOGY / ORIGINAL PAPER
Application of ultrasound-guided intranodal lymphangiography in the diagnosis and treatment of chylous ascites after abdominal surgery
1
Department of Interventional Radiology, Zhongshan Hospital, Shanghai Institute of Medical Imaging, National Clinical Research Center of Interventional Medicine, Fudan University, Shanghai, China
These authors had equal contribution to this work
Submission date: 2024-06-21
Final revision date: 2024-09-06
Acceptance date: 2024-09-21
Publication date: 2024-10-18
Corresponding author
Xudong Qu
Department of Interventional Radiology, Zhongshan Hospital, Shanghai Institute of Medical Imaging, National Clinical Research Center of Interventional Medicine, Fudan University, Shanghai, 200032, China, e-mail: qu.xudong@zs-hospital.sh.cn
Department of Interventional Radiology, Zhongshan Hospital, Shanghai Institute of Medical Imaging, National Clinical Research Center of Interventional Medicine, Fudan University, Shanghai, 200032, China, e-mail: qu.xudong@zs-hospital.sh.cn
Pol J Radiol, 2024; 89: 502-507
KEYWORDS
TOPICS
ABSTRACT
Purpose:
Chylous leakage is a serious and challenging postoperative complication. The purpose of this study was to explore the application of ultrasound-guided intranodal lymphangiography in the diagnosis and treatment of chylous ascites following abdominal surgery.
Material and methods:
Ten patients with chylous ascites after abdominal surgery after ineffective conservative treatment such as low-fat diet, parenteral nutrition, and negative pressure drainage were included in this single-center retrospective study. Of these 10 patients, 9 developed chylous ascites after liver surgery, and 1 after a radical gastrectomy.
Results:
Lymphangiography was successfully performed in all 10 patients. The average dosage of lipiodol used was 4.5 ml (range 3.5-7.0 ml). No procedure-related complications were observed after excluding unrelated factors. During lymphangiography, lipiodol leakage was directly observed in 3 cases, and in the other 5 cases, it was detected through abdominal computed tomography post-lymphangiography. Chylous ascites resolved solely through lymphangiography in 6 patients without requiring additional surgical intervention.
Conclusions:
Lymphangiography may help identify leakage sites in patients with chylous ascites unresponsive to conservative treatment and could potentially be effective in treating chylous ascites following abdominal surgery.
Chylous leakage is a serious and challenging postoperative complication. The purpose of this study was to explore the application of ultrasound-guided intranodal lymphangiography in the diagnosis and treatment of chylous ascites following abdominal surgery.
Material and methods:
Ten patients with chylous ascites after abdominal surgery after ineffective conservative treatment such as low-fat diet, parenteral nutrition, and negative pressure drainage were included in this single-center retrospective study. Of these 10 patients, 9 developed chylous ascites after liver surgery, and 1 after a radical gastrectomy.
Results:
Lymphangiography was successfully performed in all 10 patients. The average dosage of lipiodol used was 4.5 ml (range 3.5-7.0 ml). No procedure-related complications were observed after excluding unrelated factors. During lymphangiography, lipiodol leakage was directly observed in 3 cases, and in the other 5 cases, it was detected through abdominal computed tomography post-lymphangiography. Chylous ascites resolved solely through lymphangiography in 6 patients without requiring additional surgical intervention.
Conclusions:
Lymphangiography may help identify leakage sites in patients with chylous ascites unresponsive to conservative treatment and could potentially be effective in treating chylous ascites following abdominal surgery.
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