Ashida Hirokazu, Kisaki Shunsuke, Enoki Keitaro, Ojiri Hiroya
Department of Radiology, The Jikei University School of Medicine, Japan.
Interv Radiol (Higashimatsuyama). 2025 Feb 7;10:e20230039. doi: 10.22575/interventionalradiology.2023-0039. eCollection 2025 Mar 28.
Postoperative chylous ascites is a rare condition that can be caused by abdominal and pelvic surgery. The mortality rate associated with untreated postoperative lymphorrhea is as high as 50%. Conservative management is the primary treatment, and most patients improve. However, some patients continue to exhibit high-volume chylous ascites and need invasive intervention. Many surgical series have shown that the outcomes of patients with chylous ascites were unfavorable. Therefore, the need for minimally invasive interventional radiology procedures, such as intranodal lymphangiography, thoracic duct, lymphatic pseudoaneurysm, lymph node, hepatic lymphatic embolization, and peritoneovenous shunting, is increasing. This review describes the anatomy, physics, and diagnosis related to interventional radiology for postoperative chylous ascites as well as interventional radiology treatment options and strategies for this condition referring to recent literature.
术后乳糜性腹水是一种罕见的病症,可由腹部和盆腔手术引起。未经治疗的术后淋巴漏相关死亡率高达50%。保守治疗是主要治疗方法,大多数患者病情会改善。然而,一些患者仍表现出大量乳糜性腹水,需要进行有创干预。许多外科系列研究表明,乳糜性腹水患者的预后不佳。因此,对微创介入放射学程序的需求在增加,如结内淋巴管造影、胸导管、淋巴假性动脉瘤、淋巴结、肝淋巴管栓塞和腹腔静脉分流术。本综述参考近期文献,描述了与术后乳糜性腹水介入放射学相关的解剖学、物理学和诊断方法,以及针对这种病症的介入放射学治疗选择和策略。