OK-432 (Picibanil) Sclerotherapy for the Treatment of Chyle Leakage After Thyroid Surgery.

Objective: This study aimed to evaluate the safety and efficacy of OK-432 (Picibanil) sclerotherapy for the management of chyle leakage following thyroid surgery.

Materials and methods: We retrospectively reviewed the medical records of 12 consecutive patients with chyle leakage who underwent Picibanil sclerotherapy after thyroid surgery between January 2019 and December 2024. The collected data included patient demographics, clinical presentation, prior treatments, sclerotherapy details, treatment outcomes, and adverse effects. Clinical success was defined as fulfillment of all three criteria: 1) Improvement in clinical signs and symptoms, 2) Volume reduction of the chyloma without compressive effects on surrounding tissues on ultrasonography, and 3) Drainage amount of <10 mL/day (if applicable). Recurrence was defined as the reappearance of chyle leakage symptoms or re-accumulation of fluid at the previous chyloma site on follow-up imaging after initial clinical success.

Results: Among the 12 patients (median age: 45.5 years), 11 (91.7%) achieved clinical success. One patient (8.3%) did not respond to treatment and subsequently required thoracic duct embolization. The median number of sclerotherapy sessions was two (range, 1-4). Minor adverse effects, such as fever (10/12) and localized pain (4/12), were observed but resolved without long-term complications. No recurrence was noted during the median post-sclerotherapy follow-up period of 35 months (range: 10-57 months).

Conclusion: Picibanil sclerotherapy may be a safe and effective treatment for chyle leakage after thyroid surgery. It may offer a minimally invasive alternative with a high clinical success rate and minor, manageable adverse effects.