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Prediction of therapeutic effectiveness according to CT findings after therapeutic lymphangiography for lymphatic leakage

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Abstract

Purpose

To evaluate the correlation between computed tomography (CT) findings after therapeutic lymphangiography for lymphatic leakage and the clinical course of lymphatic leakage.

Materials and methods

Therapeutic lymphangiography for lymphatic leakage was performed in 14 patients. In all patients, CT was performed 0.5–26 h (mean 6.9 h) after lymphangiography and results were retrospectively evaluated.

Results

In 8 of the 14 patients (57 %), lymphatic leakage stopped after lymphangiography. Lymphatic leakage was detected on CT in 9 of the 14 patients (64 %) and had either a nodular (n = 4) or beaded appearance (n = 5). The amount of drainage had decreased the day after lymphangiography, and leakage finally stopped in all 4 patients in whom the leakage had a nodular appearance. However, leakage did not stop in 3 of the 5 patients having leakage with a beaded appearance.

Conclusion

A nodular appearance of leakage might predict success of therapeutic lymphangiography.

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References

  1. Guermazi A, Brice P, Hennequin C, Sarfati E. Lymphangiography: an old technique retains its usefulness. Radiographics. 2003;23:1541–58.

    Article  PubMed  Google Scholar 

  2. Yamagami T, Masunami T, Kato T, Tanaka O, Hirota T, Nomoto T, et al. Spontaneous healing of chyle leakage after lymphangiography. Br J Radiol. 2005;78:854–7.

    Article  CAS  PubMed  Google Scholar 

  3. Matsumoto T, Yamagami T, Kato T, Hirota T, Yoshimatsu R, Masunami, et al. The effectiveness of lymphangiography as a treatment method for various chyle leakages. Br J Radiol. 2009;82:286–90.

    Article  CAS  PubMed  Google Scholar 

  4. Kos S, Haueisen H, Lachmund U, Roeren T. Lymphangiography: forgotten tool or rising star in the diagnosis and therapy of postoperative lymphatic vessel leakage. Cardiovas Inter Radiol. 2007;30:968–73.

    Article  Google Scholar 

  5. Alejandre-Lafont E, Krompiec C, Rau WS, Krombach GA. Effectiveness of therapeutic lymphangiography on lymphatic leakage. Acta Radiol. 2011;52:305–11.

    Article  PubMed  Google Scholar 

  6. Deso S, Ludwig B, Kabutey NK, Kim D, Guermazi A. Lymphangiography in the diagnosis and localization of various chyle leaks. Cardiovas Inter Radiol. 2012;35:117–26.

    Article  Google Scholar 

  7. Ginat DT, Sahler JG, Patel N, Sadd WA, Waldam DL. Post-lymphangiographic computed tomography in chylothorax after oesophagogastrectomy: a case report. Lymphology. 2009;42:130–3.

    CAS  PubMed  Google Scholar 

  8. DeMeester T. The pleura. In: Spencer E, editor. Surgery of the chest. 4th ed. Philadelphia: WB Saunders; 1983.

    Google Scholar 

  9. Bessone L, Ferguson T, Burford T. Chylothorax: a collective review. Ann Thorac Surg. 1971;12:527–50.

    Article  CAS  PubMed  Google Scholar 

  10. Cardenas A, Chopra S. Chylous ascites. Am J Gastroenterol. 2002;97:1896–900.

    PubMed  Google Scholar 

  11. Browse NL, Wilson NM, Russo F, Al-Hassan H, Allen DR. Aetiology and treatment of chylous ascites. Br J Surg. 1992;79:1145–50.

    Article  CAS  PubMed  Google Scholar 

  12. Sultan S, Pauwels A, Poupon R, Levy VG. Chylous ascites in cirrhosis: retroperitoneal study of 20 cases. Gastroenterol Clin Biol. 1990;14:842–7.

    CAS  PubMed  Google Scholar 

  13. Casafont F, Lopez-Arias MJ, Crespo J, Duenas C, Sanchez-Antolin G, Rivero M, et al. Chylous ascites in cirrhotic and non-cirrhotic patients. Gastroenterol Hepatol. 1997;20:291–4.

    CAS  PubMed  Google Scholar 

  14. Cerfolio RJ, Allen MS, Deschamps C, Trastek VF, Pairolero PC. Postoperative chylothorax. J Thorac Cardiovas Surg. 1996;112:1361–5.

    Article  CAS  Google Scholar 

  15. Browse NL, Allen DR, Wilson NM. Management of chylothorax. Br J Surg. 1997;84:1711–6.

    Article  CAS  PubMed  Google Scholar 

  16. Aalami OO, Allen DB, Organ CH Jr. Chylous ascites: collective review. Surgery. 2000;128:761–78.

    Article  CAS  PubMed  Google Scholar 

  17. Leibovitch I, Mor Y, Golomb J, Ramon J. The diagnosis and management of postoperative chylous ascites. J Urol. 2002;167:449–57.

    Article  PubMed  Google Scholar 

  18. Rimensberger PC, Muuler-Schenker B, Kalangos A, Beghetti M. Treatment of a persistent postoperative chylothorax. Ann Thorac Surg. 1998;66:253–4.

    Article  CAS  PubMed  Google Scholar 

  19. Collard JM, Laterre PF, Boemer F, Reynaert M, Ponlot R. Conservative treatment of postsurgical lymphatic leaks with somatostatin-14. Chest. 2000;117:902–5.

    Article  CAS  PubMed  Google Scholar 

  20. Shapiro AM, Bain VG, Sigalet DL, Kneteman NM. Rapid resolution of chylous ascites after liver trasplantation using somatostatin analog and total parenteral nutrition. Transplantation. 1996;61:1410–1.

    CAS  PubMed  Google Scholar 

  21. Cope C. Diagnosis and treatment of postoperative chyle leakage via percutaneous transabdominal catheterization of the cisterna chyli: a preliminary study. J Vas Inter Radiol. 1998;9:727–34.

    Article  CAS  Google Scholar 

  22. Cope C, Salem R, Kaiser LR. Management of chylothorax by percutaneous catheterization and embolization of the thoracic duct: prospective trial. J Vas Inter Radiol. 1999;10:1248–54.

    Article  CAS  Google Scholar 

  23. Hoffer EK, Bloch RD, Mulligan MS, Borsa JJ, Fontain AB. Treatment of chylothorax: percutaneous catheterization and embolization of the thoracic duct. AJR Am J Roentgenol. 2001;176:1040–2.

    Article  CAS  PubMed  Google Scholar 

  24. Dugue L, Sauvanet A, Farges O, Goharin A, Le Mee J, Belghiti J. Output of chyle as an indicator of treatment for chylothorax complicating oesophagectomy. Br J Surg. 1998;85:1147–9.

    Article  CAS  PubMed  Google Scholar 

  25. Alexiou C, Watson M, Beggs D, Salama FD, Morgan WE. Chylothorax following oesophagogastrectomy for malignant disease. Eur J Cardiothorac Surg. 1998;14:460–6.

    Article  CAS  PubMed  Google Scholar 

  26. Wuring PN, Hollaus PH, Ohtsuka T, Flege JB, Wolf RK. Thoracoscopic direct clipping of the thoracic duct for chylopericardium and chylothorax. Ann Thorac Surg. 2000;70:1662–5.

    Article  Google Scholar 

  27. Nadolski GJ, Itkin M. Feasibility of ultrasound-guided intra-nodal lymphangiogram for thoracic duct embolization. J Vas Inter Radiol. 2012;23:613–6.

    Article  Google Scholar 

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Acknowledgments

No personal or financial support was provided for this article.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, Institute and Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minamiku, Hiroshima, 734-8551, Japan

    Rika Yoshimatsu & Takuji Yamagami

  2. Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-chyo, Kawaramachi-Hirokoji, Kamigyo, Kyoto, 602-8566, Japan

    Rika Yoshimatsu, Takuji Yamagami & Hiroshi Miura

  3. Department of Radiology, Tokai University Hachioji Hospital, 1838 Ichikawa-machi, Hachioji, Tokyo, 192-0032, Japan

    Tomohiro Matsumoto

Authors
  1. Rika Yoshimatsu
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  2. Takuji Yamagami
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  3. Hiroshi Miura
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  4. Tomohiro Matsumoto
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Corresponding author

Correspondence to Rika Yoshimatsu.

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Yoshimatsu, R., Yamagami, T., Miura, H. et al. Prediction of therapeutic effectiveness according to CT findings after therapeutic lymphangiography for lymphatic leakage. Jpn J Radiol 31, 797–802 (2013). https://doi.org/10.1007/s11604-013-0252-2

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  • DOI: https://doi.org/10.1007/s11604-013-0252-2

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