{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T12:20:33Z","timestamp":1762431633750},"reference-count":34,"publisher":"Walter de Gruyter GmbH","issue":"3","license":[{"start":{"date-parts":[[2019,9,25]],"date-time":"2019-09-25T00:00:00Z","timestamp":1569369600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,9,25]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"j_iss-2018-0037_s_999_w2aab3b7c16b1b6b1aab1c16b1Aa\"><jats:title>Objectives<\/jats:title><jats:p>Postoperative chylothorax is a serious complication after transthoracic esophagectomy, and is associated with major morbidity due to dehydration and malnutrition. For patients with high-output fistula, re-thoracotomy with ligation of the thoracic duct is the treatment of choice. Radiologic interventional management is an innovative procedure that has the potential to replace surgery in the treatment algorithm.<\/jats:p><\/jats:sec><jats:sec id=\"j_iss-2018-0037_s_998_w2aab3b7c16b1b6b1aab1c16b2Aa\"><jats:title>Methods<\/jats:title><jats:p>Four patients with high-output chylous leaks following esophagectomy are presented. Ultrasound-guided lymphangiography with embolization of the thoracic duct and\/or disruption of the cisterna chyli was performed to occlude the leakage site. Radiologic interventions and procedure-related outcomes are described in detail.<\/jats:p><\/jats:sec><jats:sec id=\"j_iss-2018-0037_s_997_w2aab3b7c16b1b6b1aab1c16b3Aa\"><jats:title>Results<\/jats:title><jats:p>In all four patients, ultrasound-guided lymphangiography of the groin with injection of Lipiodol was able to detect and visualize the leakage site in the lower mediastinum. In three patients, the leak could be successfully occluded by Lipiodol embolization. In one patient, embolization failed and the disruption technique was successfully performed. No procedure-related complications were observed.<\/jats:p><\/jats:sec><jats:sec id=\"j_iss-2018-0037_s_996_w2aab3b7c16b1b6b1aab1c16b4Aa\"><jats:title>Conclusions<\/jats:title><jats:p>In case of a postoperative chylothorax, radiologic intervention is feasible and safe. The procedure is indicated for high-output chylous fistulas after esophagectomy, and should be applied early after the diagnosis of this postoperative complication.<\/jats:p><\/jats:sec>","DOI":"10.1515\/iss-2018-0037","type":"journal-article","created":{"date-parts":[[2019,3,9]],"date-time":"2019-03-09T15:35:17Z","timestamp":1552145717000},"page":"85-90","source":"Crossref","is-referenced-by-count":3,"title":["Ultrasound-guided lymphangiography and interventional embolization of chylous leaks following esophagectomy"],"prefix":"10.1515","volume":"4","author":[{"given":"Rolf","family":"Lambertz","sequence":"first","affiliation":[{"name":"Department of General, Visceral and Cancer Surgery, University of Cologne, Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"De-hua","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Cologne, Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tilman","family":"Hickethier","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Cologne, Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahsa","family":"Bagheri","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Cancer Surgery, University of Cologne, Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica M.","family":"Leers","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Cancer Surgery, University of Cologne, Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christiane J.","family":"Bruns","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Cancer Surgery, University of Cologne, Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolfgang","family":"Schr\u00f6der","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Cancer Surgery, University of Cologne, Kerpener Str. 62, Cologne 50937, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","reference":[{"key":"ref331","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1053\/j.tvir.2016.10.010","article-title":"Lymphangiography for thoracic duct interventions","volume":"19","year":"2016","journal-title":"Tech Vasc Interv Radiol"},{"key":"ref231","doi-asserted-by":"crossref","first-page":"1398","DOI":"10.1016\/j.jvir.2014.03.027","article-title":"Thoracic duct embolization and disruption for treatment of chylous effusions: experience with 105 patients","volume":"25","year":"2014","journal-title":"J Vasc Interv 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