Lim Hunjong, Choi Sang Il
Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea.
Korean J Radiol. 2025 Jul;26(7):727-733. doi: 10.3348/kjr.2025.0230. Epub 2025 Apr 29.
This study aimed to evaluate the safety and efficacy of OK-432 (Picibanil) sclerotherapy for the management of chyle leakage following thyroid surgery.
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.
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).
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.
本研究旨在评估溶链菌制剂（沙培林）硬化疗法治疗甲状腺术后乳糜漏的安全性和有效性。
我们回顾性分析了2019年1月至2024年12月期间12例连续甲状腺术后发生乳糜漏并接受沙培林硬化疗法的患者的病历。收集的数据包括患者人口统计学资料、临床表现、既往治疗情况、硬化疗法详细信息、治疗结果和不良反应。临床成功定义为满足以下所有三项标准：1）临床体征和症状改善；2）乳糜瘤体积缩小，超声检查对周围组织无压迫作用；3）引流量<10 mL/天（如适用）。复发定义为初始临床成功后随访影像学检查时，乳糜漏症状再次出现或先前乳糜瘤部位再次积液。
12例患者（中位年龄：45.5岁）中，11例（91.7%）获得临床成功。1例患者（8.3%）治疗无效，随后需要进行胸导管栓塞术。硬化疗法的中位疗程为2次（范围：1 - 4次）。观察到轻微不良反应，如发热（10/12）和局部疼痛（4/12），但均未导致长期并发症而缓解。硬化疗法后中位随访35个月（范围：10 - 57个月）期间未发现复发。
沙培林硬化疗法可能是治疗甲状腺术后乳糜漏的一种安全有效的方法。它可能提供一种微创替代方案，临床成功率高，不良反应轻微且易于处理。
