Low thoracic duct ligation for postoperative chylous effusions in infants and children

Three patients aged from three months to six years underwent thoracic duct ligation at the level of the diaphragm for chylothorax which occurred following cardiac operations. Another three-month-old patient underwent thoracic duct ligation for massive postoperative chylopericardium. Indications for operation were a large recurrent chyle accumulation or prolonged chyle drainage. Operative ductograms to deliniate the cisterna chyli and to exclude the presence of multiple lymph channels were performed in three patients. Excellent postoperative results were obtained in all patients for periods of up to two years. Low thoracic dust ligation is a reliable means of control of postoperative chylothorax and lengthy persistence with conservative treatment is no longer necessary.