Comparison of the Effectiveness of Inguinal Lymphangiography and Transjugular Intrahepatic Portosystemic Shunt Creation in Cirrhosis-Related Chylous Ascites.

To investigate the effectiveness of ethiodized oil lymphangiography and transjugular intrahepatic portosystemic shunt (TIPS) creation in cirrhosis-related chylous ascites, 10 patients were included between January 2019 and December 2023. After the failure of conservative treatment, patients underwent inguinal nodal ethiodized oil lymphangiography to identify and embolize the chylous leakage first, and then, the TIPS procedure was performed. Symptoms of chylous leakage were not controlled after ethiodized oil lymphangiography, including patients' weight increase, abdominal circumference increase, and serum albumin level decrease. After undergoing TIPS procedure 1 week later, chylous ascites was gradually alleviated, manifested as weight decrease, abdominal circumference decrease, and serum albumin level maintenance. In mean follow-up of 15.6 months (SD ± 11.6), all chylous ascites was relieved without recurrence. In summary, ethiodized oil inguinal node lymphangiography was not capable of identifying and controlling lymphatic leakage; however, TIPS creation was an effective method to control chylous ascites in patients with cirrhosis.