title: Therapeutic effectiveness of diagnostic lymphangiography for refractory postoperative chylothorax and chylous ascites: correlation with radiologic findings and preceding medical treatment.
abstract: OBJECTIVE
  The purpose of this study was to assess the therapeutic effect of lymphangiography for refractory postoperative chylothorax and chylous ascites and analyze the relation between the clinical outcomes and radiologic findings or response to the preceding medical treatment.
  
  
  METHODS
  Between January 2004 and June 2012, 14 patients underwent lymphangiography. All patients had been unresponsive to at least two medical treatments for 3-62 days (median, 13.5 days) before lymphangiography. Leaks were classified as major, minor, and undetectable on the basis of radiologic findings including CT and conventional radiography after lymphangiography. The clinical outcomes were correlated with the radiologic findings or the changes of the daily chylous output after the preceding medical treatments.
  
  
  RESULTS
  The leaks were healed in nine of 14 patients (64.3%) by 3-29 days (median, 8 days) after lymphangiography. Healing was achieved for two of seven major leaks, and all of the minor leaks (n=4) and undetectable leaks (n=3) after lymphangiography. The remaining five major leaks were not healed after a median follow-up of 15 days. The daily output decreased more than half after medical treatment in seven of the 14 patients, and the leak was healed in six of these patients (85.7%) by 5-18 days (median, 10 days).
  
  
  CONCLUSIONS
  Lymphangiography might be useful for the treatment of refractory postoperative chylothorax and chylous ascites.
authors: Department of Radiology, Hyogo Brain and Heart Center at Himeji, 520, Saisho-Ko, Himeji, Hyogo, Japan 670-0981. kawaryo1999@yahoo.co.jp
authors: Ryota
authors: R
authors: Kawasaki
authors: Koji
authors: K
authors: Sugimoto
authors: Masahiko
authors: M
authors: Fujii
authors: Naokazu
authors: N
authors: Miyamoto
authors: Takuya
authors: T
authors: Okada
authors: Masato
authors: M
authors: Yamaguchi
authors: Kazuro
authors: K
authors: Sugimura
mesh_terms: D000368:Aged; D002916:Chylothorax / Q000000981:diagnostic imaging*; D002915:Chylous Ascites / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008220:Lymphography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D016896:Treatment Outcome