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Case Reports
. 2021 Dec 16;17(3):549-552.
doi: 10.1016/j.radcr.2021.11.070. eCollection 2022 Mar.

Percutaneous embolization of hepatic lymphorrhea post-hepatectomy

Le Viet Dung  1 , Nguyen Thai Binh  1   2 , Le Tuan Linh  1   2 , Phan Nhan Hien  1 , Tran Ngoc Dung  3 , Tran Bao Long  3 , Thieu-Thi Tra My  1 , Nguyen Minh Duc  4
Affiliations
Case Reports

Percutaneous embolization of hepatic lymphorrhea post-hepatectomy

Le Viet Dung et al. Radiol Case Rep. .

Abstract

Abdominal effusion due to hepatic lymphorrhea post-hepatectomy is an extremely rare and complex complication in clinical practice. No standard treatment method has been established for this condition to date. We report a case of complicated intra-abdominal lymphatic leakage in a patient following hepatectomy to treat hepatocellular carcinoma. The patient underwent percutaneous embolization of the hilar hepatic lymphatic system, combined with intensive medical treatment. Percutaneous embolization represents a safe and effective method that should be considered as a first-line treatment for this complication.

Keywords: Embolization; Hepatectomy; Lymphatic leakage; Lymphorrhea; Percutaneous intervention.

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Figures

Fig. 1 –
Fig. 1 –
MRI lymphangiography through the inguinal lymph nodes revealed no damage to the cisterna chyli (thin arrow) or thoracic duct (block arrow).
Fig. 2 –
Fig. 2 –
Percutaneous hepatic lymphangiography and embolization with Histoacryl. Green arrow in A: Lymphatic branches of the hepatic hilum. Blue arrows in B and C: 25G Chiba needle. Green arrow in D: Lymphatic fistula in the hepatic hilum.
Fig. 3 –
Fig. 3 –
Line graph showing the amount of lymphatic fluid drainage each day after hepatectomy.
Fig. 4 –
Fig. 4 –
Computed tomography image after 1 month showed embolic material deposited in the hilar hepatic lymphatic system (arrow).
See this image and copyright information in PMC

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