Int J Thyroidol.  2020 May;13(1):47-50. 10.11106/ijt.2020.13.1.47.

Thoracic Duct Embolization for Chyle Leakage after Thyroid Surgery

• Lee I
• Kim HK
• Lee J
• Soh EY
• Kim J

• KMID: 2502260
• DOI: http://doi.org/10.11106/ijt.2020.13.1.47

Abstract

Chyle leakage (CL) due to lymphatic injuries is one of the rare complications that can develop after thyroidectomy. There are few studies on lymphatic embolization performed in case of CL after thyroid surgery. We report two cases of CL after thyroid surgery that were effectively treated by thoracic duct embolization. The patients had previously undergone total thyroidectomy with central compartment neck dissection with or without modified radical neck dissection. The amount of drainage from the operative site was ＞1000 mL per day in one patient and ＞500 mL per day in the other. In both cases, CL stopped after the thoracic duct embolization. Thoracic duct embolization seems to be an effective and important treatment option for CL after thyroid surgery.

Keyword

Thoracic duct; Chyle; Thyroid gland; Thyroidectomy

Figure

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  Fig. 1 A single lymph node in the right thigh was punctured using a 25-G needle.

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  Fig. 2 The leakage site was detected near the cervical portion of the thoracic duct.

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  Fig. 3 The cisterna chyli was accessed using a 22-G needle, followed by co-axial delivery of a 2.0-Fr microcatheter into the thoracic duct.

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  Fig. 4 Coil and glue were used to embolize the distal thoracic duct just below site of leakage.

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  Fig. 5 Post-embolization state.

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