ArticleCureus2026
Early Thoracic Duct Ligation for Post-esophagectomy Chyle Leak: A 10-Year Institutional Experience With Early Operative Intervention.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
5 authors.
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Abstract
Background and aim Chyle leak is a rare but potentially lethal complication following esophagectomy. Optimal timing for thoracic duct ligation remains unclear, particularly for high-output leaks. This study aimed to evaluate outcomes of early thoracic duct ligation compared with conservative therapy in post-esophagectomy chyle leak. Methods This is a retrospective study of 500 patients undergoing esophagectomy from 2016 to 2025 at a tertiary cancer center. Six patients (1.2%) developed chyle leak. Diagnosis was based on high-volume drainage, milky effluent after feeding, and biochemical confirmation. Conservative treatment included drainage, nil per oral, and total parenteral nutrition. Early thoracic duct ligation was performed via a transthoracic or transabdominal approach. Statistical tests included the t-test and Fisher's exact test. Results Patients with chyle leak were significantly younger than those without leak (44.0±5.7 vs. 53.2±13.4 years; p=0.009). Conservative therapy (n=1) resulted in persistent leak and death (100% mortality). Early surgical ligation (n=5) achieved 100% resolution with no mortality and shorter hospital stay (13-14 days vs. 18 days). Overall mortality in the chyle-leak group was 16.7%, exclusively in the conservatively treated patient. Conclusion Early thoracic duct ligation appears to be a safe and effective strategy in selected high-output post-esophagectomy chyle leaks in our institutional experience. Prolonged conservative therapy in high-output leaks is associated with avoidable morbidity and mortality.
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