British Journal of Radiology · 2009 · 229 citations · 17 references
MedicineClinical SciencesSurgeryGastroenterologyLymphedema SurgeryPulmonologyFistula ManagementLymphatic InterventionsChyle Leak ManagementDrainageLymphatic FistulaLymphatic Leak ManagementLymphatic LeakageMedium-chain Triglyceride DietPedal LymphangiographyRecurrence After Conservative Treatment
The purpose of this study was to assess the effectiveness of lymphangiography as a treatment for various chyle leakages. Pedal lymphangiography was performed in 9 patients (6 men and 3 women; mean age, 59 years) who were unlikely to be cured only by conservative treatment - a low-fat medium-chain triglyceride diet, total parenteral nutrition and insertion of a drainage tube - and in whom chylothorax (n = 5), chylous ascites (n = 2) and lymphatic fistulae (n = 2) were refractory to conservative treatment. In 7 of these 9 patients (78%), we could detect the chyle leakage sites. In 8 of the 9 patients (89%), lymphatic leakage was stopped after lymphangiography, and surgical re-intervention was avoided. No cases had a recurrence of chyle leakage during follow-up (range, 1-54 months). Lymphangiography is effective not only for diagnosis but also as treatment for various chyle leakages. Early lymphangiography is therefore recommended for patients with chyle leakages who are unlikely to be cured by conservative treatment only.
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Robert J. Cerfolio, Mark S. Allen, Claude Deschamps et al. · Journal of Thoracic and Cardiovascular Surgery · 1996 · 328 citations · Full text
Aetiology and treatment of chylous ascites
N L Browse, Nick Wilson, Francesco Paolo Russo et al. · British journal of surgery · 1992 · 236 citations