Abstract
Post-esophagectomy chylothorax is a therapeutic dilemma. Understanding anatomy and leakage site is essential, although imaging techniques for thoracic lymphatics are challenging and not always available. We describe a patient with chylothorax post-esophagectomy from a left-sided thoracic duct traversing to the right chest. We applied intranodal Lipiodol® lymphangiography, computed tomographic lymphangiography, and performed fluorescence-guided thoracic duct ligation at the level of the aortic arch. These techniques are not only useful in a postoperative setting but may be used as preventive strategies to reduce morbidity and mortality from chylothorax after any thoracic surgical procedure where the thoracic duct is at risk.
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