Treatment of cervical chylous fistula under the guidance of lymphangiography

中华普通外科杂志 Pub Date : 2019-12-25 DOI:10.3760/CMA.J.ISSN.1007-631X.2019.12.010

W. Su, Yuguang Sun, S. Xia, W. Shen

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Abstract

Objective To investigate the clinical value of lymphangiography in the diagnosis and treatment of cervical chylous fistula. Methods The clinical data of 7 patients with chylous fistula at Department of Lymph Surgery, Capital Medical University Affiliated Beijing Shijitan Hospital from Jul 2010 to Aug 2015 was retrospectively analyzed. Lymphangiography was performed to investigate the site of fistula and condition of thoracic duct. Results There were 1 male and 6 female patients aging from 22 to 59 years.All patients underwent lymphangiography successfully with dynamic imaging clearly, which accurately showed the location of the leakage and the anatomy of the thoracic duct. There was compensatory branch or trunk drainage in 2 cases which underwent successful conservative treatment, the other 5 cases with leak>500 ml a day without clear compensatory branch underwent surgical treatment and were cured with no major complications. Conclusion Lymphangiography not only clearly locates the leakage and anatomical relationship of the thoracic duct, but also guides the choice of treatment and precise surgery, avoiding the secondary injury. Key words: Lymphography; Thoracic duct; Chylous fistula

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淋巴管造影引导下治疗宫颈乳糜瘘

目的探讨颈淋巴管造影在颈乳糜瘘诊断和治疗中的临床价值。方法回顾性分析2010年7月至2015年8月首都医科大学附属北京世纪坛医院淋巴外科收治的7例乳糜瘘患者的临床资料。行淋巴管造影检查瘘口部位及胸导管情况。结果男性1例，女性6例，年龄22 ~ 59岁。所有患者均顺利行淋巴管造影，动态显像清晰，准确显示渗漏部位及胸导管解剖结构。2例有代偿分支或主干引流，保守治疗成功，其余5例每日漏血500ml，代偿分支不清，行手术治疗，均治愈，无重大并发症。结论淋巴管造影可明确胸导管渗漏的位置及解剖关系，指导治疗方法的选择和精确手术，避免继发性损伤。关键词:淋巴造影术;胸导管;乳糜瘘

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中华普通外科杂志

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