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Therapeutic lymphography for persistent chyle leak after pancreatic surgery
Rosa Klotz1, Charlotte Kuner1, Feng Pan2
1Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany.
Summary
Therapeutic lymphography effectively treats severe chyle leaks following pancreatic surgery when conservative methods fail. This safe procedure offers a viable option for managing post-pancreatic surgery complications.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Interventional Radiology
Background:
- Chyle leak is a frequent complication after pancreatic surgery.
- Conservative treatments for chyle leak often fail.
- Lymphography is considered a last-resort therapeutic option.
Purpose of the Study:
- To assess the efficacy of lymphography for severe (Grade C) chyle leaks post-pancreatic surgery.
Main Methods:
- A retrospective analysis of patients with Grade C chyle leak undergoing therapeutic lymphography (2010-2020).
- Clinical success defined by >50% (partial) or >85% (complete) reduction in drainage output post-procedure.
Main Results:
- Lymphography was clinically successful in 23 of 48 patients (48%).
- Complete and partial success rates were 19% and 29%, respectively.
- Successful lymphography correlated with earlier drain removal and hospital discharge (p=0.006).
- No serious adverse events were reported.
Conclusions:
- Therapeutic lymphography is a feasible and safe treatment for Grade C chyle leaks after pancreatic surgery.
- It offers an effective alternative when conservative management fails.
