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KMID : 0361120230370020124
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Korean Journal of Transplantation
2023 Volume.37 No. 2 p.124 ~ p.128
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Right lumbar lymph trunk injury after right laparoscopic donor nephrectomy: a case report
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Le Thanh Dung
Le Nguyen Vu
Than Van Sy
Tran Ha Phuong
Ninh Viet Khai
Kim Seung-Chan
Nguyen Quang Nghia
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Abstract
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Laparoscopic donor nephrectomy (LDN) is increasingly popular because of its advantages over open surgery. Chyle leak after donor nephrectomy is a rare but potentially lethal complication if not treated appropriately. We describe a case of a 43-year-old female patient with no remarkable history who presented a chyle leak on day 2 after right transperitoneal LDN. Since conservative treatment failed, the patient underwent magnetic resonance imaging (MRI) and intranodal lipiodol lymphangiography, which confirmed the chyle leak from the right lumbar lymph trunk into the right renal fossa. The chyle leak was percutaneously embolized twice, on postoperative day (POD) 5 and POD 10, by a mixture of N-butyl-2-cyanoacrylate and lipiodol. The drainage fluid decreased significantly after the second embolization. The subhepatic drainage tube was withdrawn on POD 14, and the patient was discharged on POD 17. MRI lymphangiography and intranodal lipiodol lymphangiography effectively identified the chyle leak point. Percutaneous embolization seems to be a safe, effective method for treating high-output chyle leaks.
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KEYWORD
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Cyanoacrylate, Embolization, Lymphangiography, Lymphatic vessels, Nephrectomy
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