Universität zu Köln

Lambertz, Rolf, Chang, De-hua, Hickethier, Tilman, Bagheri, Mahsa, Leers, Jessica M., Bruns, Christiane J. and Schroeder, Wolfgang (2019). Ultrasound-guided lymphangiography and interventional embolization of chylous leaks following esophagectomy. Innov. Surg. Sci., 4 (3). S. 85 - 93. BERLIN: WALTER DE GRUYTER GMBH. ISSN 2364-7485

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Abstract

Objectives: Postoperative chylothorax is a serious complication after transthoracic esophagectomy, and is associated with major morbidity due to dehydration and malnutrition. For patients with high-output fistula, rethoracotomy with ligation of the thoracic duct is the treatment of choice. Radiologic interventional management is an innovative procedure that has the potential to replace surgery in the treatment algorithm. Methods: Four patients with high-output chylous leaks following esophagectomy are presented. Ultrasound-guided lymphangiography with embolization of the thoracic duct and/or disruption of the cisterna chyli was performed to occlude the leakage site. Radiologic interventions and procedure-related outcomes are described in detail. Results: In all four patients, ultrasound-guided lymphangiography of the groin with injection of Lipiodol was able to detect and visualize the leakage site in the lower mediastinum. In three patients, the leak could be successfully occluded by Lipiodol embolization. In one patient, embolization failed and the disruption technique was successfully performed. No procedure-related complications were observed. Conclusions: In case of a postoperative chylothorax, radiologic intervention is feasible and safe. The procedure is indicated for high-output chylous fistulas after esophagectomy, and should be applied early after the diagnosis of this postoperative complication.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Lambertz, Rolf UNSPECIFIED UNSPECIFIED UNSPECIFIED Chang, De-hua UNSPECIFIED UNSPECIFIED UNSPECIFIED Hickethier, Tilman UNSPECIFIED UNSPECIFIED UNSPECIFIED Bagheri, Mahsa UNSPECIFIED UNSPECIFIED UNSPECIFIED Leers, Jessica M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bruns, Christiane J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schroeder, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-142105
DOI:	10.1515/iss-2018-0037
Journal or Publication Title:	Innov. Surg. Sci.
Volume:	4
Number:	3
Page Range:	S. 85 - 93
Date:	2019
Publisher:	WALTER DE GRUYTER GMBH
Place of Publication:	BERLIN
ISSN:	2364-7485
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language THORACIC-DUCT EMBOLIZATION; INTRANODAL LYMPHANGIOGRAPHY; LIPIODOL LYMPHANGIOGRAPHY; CHYLOTHORAX; EXPERIENCE; MANAGEMENT Multiple languages Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/14210