Therapeutic lymphangiography with ethiodized oil for the management of lymphoceles and chylous ascites

Elsevier

Available online 18 May 2023

Diagnostic and Interventional ImagingAuthor links open overlay panel, , , , , , , , Highlights•

Percutaneous intranodal ethiodized oil (Lipiodol®) based lymphangiography can be used for the management of refractory pelvic lymphoceles or chylous ascites using high doses of ethiodized oil.

Percutaneous intranodal ethiodized oil (Lipiodol®) based lymphangiography using high doses of ethiodized oil is a minimally invasive, safe and effective treatment of postoperative pelvic lymphocele or chylous ascites, with a clinical success of 88%.

Several Lipiodol®-based lymphangiography sessions may be needed for obtaining clinical success.

AbstractPurpose

The purpose of this study was to analyze the safety, technical success and clinical outcome of percutaneous intranodal ethiodized oil (Lipiodol®) based lymphangiography (L-LAG) for the management of refractory pelvic lymphoceles or chylous ascites using high doses of ethiodized oil.

Materials and methods

Thirty-four patients presenting with symptomatic, refractory postoperative pelvic lymphocele or chylous ascites referred for theranostic, inguinal, intranodal L-LAG treatment between May 2018 and November 2021 were retrospectively included. There were 21 men and 13 women, with a mean age of 62.7 ± 16.2 (standard deviation) years (age range: 9–86 years), who underwent a total of 49 L-LAG for the management of lymphoceles (n = 14), chylous ascites (n = 18) or a combination of lymphocele and chylous ascites (n = 2). Clinical and radiological pre-interventional, procedural and follow-up data up to January 2022 were collected from patients’ electronic medical records and imaging files.

Results

Technical success was obtained in 48 out of 49 L-LAG (98%). No complications related to L-LAG were noted. After one or more L-LAG, clinical success was obtained in 30 patients (88%) with a mean of 1.4 interventions per patient and mean intranodal injected volume of 29 mL of ethiodized oil per session. The remaining four patients (12%), with one or more failed L-LAG, underwent additional surgical intervention to definitively treat the postoperative lymphatic leakage.

Conclusion

L-LAG using high doses of ethiodized oil is a minimally invasive, safe and effective treatment of postoperative pelvic lymphocele or chylous ascites. Multiple sessions may be needed to obtain a meaningful clinical result.

Keywords

Chylous ascites

Ethiodized oil

Lymphangiography

Postoperative lymphocele

AbbreviationsL-LAG

Lipiodol-lymphangiography

© 2023 The Author(s). Published by Elsevier Masson SAS on behalf of Société française de radiologie.

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