Retrograde Cannulation of the Thoracic Duct and Embolization of the Cisterna Chyli in the Treatment of Chylous Ascites

2008 ◽  
Vol 19 (2) ◽  
pp. 285-290 ◽  
Author(s):  
Derek Mittleider ◽  
Thomas A. Dykes ◽  
Kenneth P. Cicuto ◽  
Steven M. Amberson ◽  
Charles R. Leusner
Keyword(s):  
Thoracic Duct ◽  
Chylous Ascites ◽  
Cisterna Chyli

Reticuloendothelial System: Vascular, Nonvascular, and Oncologic

2018 ◽  
pp. 626-638
Author(s):  
Ernesto Santos ◽  
Joshua Pinter ◽  
Kevin McCluskey
Keyword(s):  
Thoracic Duct ◽  
Therapeutic Option ◽  
Chylous Ascites ◽  
Reticuloendothelial System ◽  
Arterial Aneurysm ◽  
Phagocytic Cells ◽  
Splenic Neoplasm ◽  
Lymphatic Fistula ◽  
Splenic Biopsy ◽  
Clinical Conditions

The reticuloendothelial system is the portion of the immune system consisting of phagocytic cells found in reticular connective tissue in the spleen, liver, lungs, bone marrow, and lymph nodes. For the purposes of this chapter, the discussion will be limited to interventions within the spleen and the lymphatic system. Splenic arterial interventions are performed to treat a variety of clinical conditions, including abdominal trauma, hypersplenism, splenic arterial aneurysm/pseudoaneurysm, portal hypertension, and splenic neoplasm, and they provide an alternative to open surgery. Although not commonly performed, percutaneous splenic biopsy and drainage are relatively safe and efficacious procedures. Lymphangiography is a therapeutic option for patients with chylothorax, chylous ascites, and lymphatic fistula. Percutaneous thoracic duct embolization (TDE) is an alternative to surgical ligation of the thoracic duct (TD).

Congenital chylous ascites: Lymphangiographic demonstration of obstruction of the cisterna chyli and chylous reflux into the peritoneal space and small intestine

1967 ◽  
Vol 70 (3) ◽  
pp. 340-345 ◽  
Author(s):  
Clinton E. Craven ◽  
Armond S. Goldman ◽  
Duane L. Larson ◽  
Marcel Patterson ◽  
Charles K. Hendrick
Keyword(s):  
Small Intestine ◽  
Chylous Ascites ◽  
Cisterna Chyli ◽  
Peritoneal Space ◽  
Chylous Reflux

scholarly journals First successful case of percutaneous transabdominal thoracic duct embolization (PTTDE) for chylous ascites resulting from laparoscopic gastric cancer surgery

2021 ◽  
Author(s):  
Hideyuki Yokokawa ◽  
Takao Katsube ◽  
Miki Miyazawa ◽  
Ryohei Nishiguchi ◽  
Shinichi Asaka ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Thoracic Duct ◽  
Distal Gastrectomy ◽  
Oral Intake ◽  
Chylous Ascites ◽  
Albumin Concentration ◽  
Serum Albumin Concentration ◽  
Node Dissection ◽  
Gastric Cancer Surgery ◽  
Successful Case

AbstractA 61-year-old woman underwent laparoscopy-assisted distal gastrectomy (LADG) with extragastric lymph node dissection (D2). Two months later, she was readmitted to hospital to be treated for chylous ascites. Oral intake was discontinued and total parenteral nutrition started, but increasing body weight and decreasing serum albumin concentration was not controllable. Percutaneous transabdominal thoracic duct embolization (PTTDE) was performed on the 8th day after the readmission. Five days after PTTDE, oral intake was resumed. Seventeen days after PTTDE, the patient was discharged without recurrence of ascites. She has remained asymptomatic. We describe here the first patient with chylous ascites two months after LADG with D2 dissection for early gastric cancer who was successfully treated by PTTDE.

Chylous Ascites: A Rare Complication of Thoracic Duct Embolization for Chylothorax

2010 ◽  
Vol 34 (S2) ◽  
pp. 245-249 ◽  
Author(s):  
Ron C. Gaba ◽  
Charles A. Owens ◽  
James T. Bui ◽  
Tami C. Carrillo ◽  
M. Grace Knuttinen
Keyword(s):  
Thoracic Duct ◽  
Rare Complication ◽  
Chylous Ascites

scholarly journals Therapeutic Intranodal Lymphangiography for Refractory Chylous Ascites Complicating Acute Necrotic Pancreatitis

2018 ◽  
Vol 27 (2) ◽  
pp. 195-197 ◽  
Author(s):  
Thomas Jardinet ◽  
Len Verbeke ◽  
Lawrence Bonne ◽  
Geert Maleux
Keyword(s):  
Rare Complication ◽  
Chylous Ascites ◽  
Invasive Treatment ◽  
Chyle Leak ◽  
Cisterna Chyli ◽  
Severe Pancreatitis ◽  
Necrotic Pancreatitis ◽  
Chyle Leakage ◽  
First Time ◽  
Intranodal Lymphangiography

Chylous ascites is a rare complication of acute pancreatitis. However, the incidence of intraperitoneal chyle leakage related to severe pancreatitis may be much higher. This is probably the result of direct damage to the cisterna chyli or its tributaries by pancreatic enzymes. In this case, conservative treatment failed to resolve the chyle leak. For the first time, to our knowledge, ultrasound guided therapeutic intranodal lymphangiography was shown to be a successful, minimally invasive treatment option in chylous ascites complicating acute necrotic pancreatitis.

scholarly journals PERCUTANEOUS FLUOROSCOPICALLY-GUIDED TRANSCERVICAL RETROGRADE ACCESS FACILITATES SUCCESSFUL THORACIC DUCT EMBOLIZATION AFTER FAILED ANTEGRADE TRANSABDOMINAL ACCESS

Lymphology ◽  
2019 ◽  
Vol 52 (2) ◽  
Author(s):  
JJ Bundy ◽  
JFB Chick ◽  
A Jiao ◽  
MR Cline ◽  
RN Srinivasa ◽  
...  
Keyword(s):  
Adverse Events ◽  
Thoracic Duct ◽  
Clinical Success ◽  
Stent Grafts ◽  
Transcervical Approach ◽  
Cisterna Chyli ◽  
Thoracic Duct Injury ◽  
Ethiodized Oil ◽  
Median Blood Loss

The purpose of this study was to demonstrate the feasibility of percutaneous fluoroscopically-guided transcervical retrograde access into the thoracic duct following unsuccessful transabdominal cisterna chyli cannulation to perform thoracic duct embolization for the treatment of chylothorax. Five patients, including three (60%) women and two (40%) men, with median age of 62 years, underwent percutaneous transcervical thoracic duct access and embolization after failed transabdominal cisterna chyli cannulation for the treatment of chylothorax. In all patients, fluoroscopically-guided percutaneous transcervical retrograde access into the distal thoracic duct was achieved using a 21-gauge needle and an 0.018-inch wire. Following advancement of a microcatheter, retrograde lymphangiography was performed to identify the location of thoracic duct injury. A combination of 2:1 ethiodized oil to cyanoacrylate mixtures, platinum microcoils, or stent-grafts were used to treat the chylous leaks. Technical successes, procedure durations, fluoroscopy times, blood losses, immediate adverse events, clinical successes, and follow-up durations were recorded. Technical success was defined as cannulation of the distal thoracic duct using a transcervical approach followed by treatment of the thoracic duct injury. Adverse events were classified according to the Society of Interventional Radiology guidelines. Clinical success was defined as resolution of the presenting chylothorax. Percutaneous transcervical retrograde thoracic duct access and treatment was technically successful in all patients (n=5). Median procedure duration was 173 minutes (range: 136-347 minutes) with a median fluoroscopy time of 94.7 minutes (range: 47-125 minutes). Median blood loss was 10 mL (range: 5-20 mL). No minor or major adverse occurred. Clinical success was achieved in all patients (n=5). Median follow-up was 372 days (range:67-661 days). Percutaneous fluoroscopically-guided transcervical retrograde thoracic duct access is an effective and safe method to perform thoracic duct embolization following unsuccessful transabdominal cisterna chyli cannulation for the treatment of chylothorax.

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