[Thoracoscopic clipping of thoracic duct in a woman with persisting chylothorax].
A 78-year-old female had chest pain, radiating to the back, caused by a thoracic aneurysm of the aorta. A vascular prosthesis was sutured into place through a left-sided thoracotomy. Six days after the operation she developed chylothorax on the right side. Following 14 days of conservative management, chyle leakage persisted at a rate of 1500 ml per 24 hours. By thoracoscopy the thoracic duct was dissected and clipped, which stopped the chyle leakage. The patient recovered moderately well. Conservative measures, such as adjusted nutrition, are successful in 50% of patients. Clipping of the thoracic duct by thoracoscopy is a definitive and minimally invasive procedure to treat persistent chyle leakage.
Willemsen
H W
HW
Academisch Ziekenhuis Vrije Universiteit, De Boelelaan 1117, 1081 HV Amsterdam.
Girbes
A R
AR
Borgstein
P J
PJ
Wisselink
W
W
van Mourik
J C
JC
Rauwerda
J A
JA
D000368:Aged; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D002908:Chronic Disease; D002916:Chylothorax / Q000209:etiology*; D005260:Female; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D013525:Surgical Instruments; D013897:Thoracic Duct / Q000293:injuries* / Q000601:surgery*; D013906:Thoracoscopy; D013908:Thoracotomy / Q000009:adverse effects*; D016896:Treatment Outcome