Application of ultrasound-guided intranodal lymphangiography in the diagnosis and treatment of chylous ascites after abdominal surgery

Purpose: Chylous leakage is a serious and challenging postoperative complication. The purpose of this study was to explore the application of ultrasound-guided intranodal lymphangiography in the diagnosis and treatment of chylous ascites following abdominal surgery.

Material and methods: Ten patients with chylous ascites after abdominal surgery after ineffective conservative treatment such as low-fat diet, parenteral nutrition, and negative pressure drainage were included in this single-center retrospective study. Of these 10 patients, 9 developed chylous ascites after liver surgery, and 1 after a radical gastrectomy.

Results: Lymphangiography was successfully performed in all 10 patients. The average dosage of lipiodol used was 4.5 ml (range 3.5-7.0 ml). No procedure-related complications were observed after excluding unrelated factors. During lymphangiography, lipiodol leakage was directly observed in 3 cases, and in the other 5 cases, it was detected through abdominal computed tomography post-lymphangiography. Chylous ascites resolved solely through lymphangiography in 6 patients without requiring additional surgical intervention.

Conclusions: Lymphangiography may help identify leakage sites in patients with chylous ascites unresponsive to conservative treatment and could potentially be effective in treating chylous ascites following abdominal surgery.