Use of LeVeen pleuroperitoneal shunt for refractory high-volume chylothorax

The Annals of Thoracic Surgery
Dipin GuptaDaniel T Dempsey

Abstract

We present a case of intractable high-volume (> 2L/d) chylothorax after transhiatal esophagectomy treated successfully with the simultaneous insertion of both Denver (Denver Biomedical, Golden, CO) and LeVeen (Becton-Dickinson, Rutherford, NJ) pleuroperitoneal shunts. The patient initially had chemoradiotherapy for a T4N1 squamous cell carcinoma of the thoracic esophagus. Re-staging showed a dramatic shrinkage of tumor, and a transhiatal esophagectomy was performed. Sequential bilateral thoracotomies were performed on postoperative days 19 and 26 for attempted control of high-volume chylothorax, but these were unsuccessful. Subsequent pleuroperitoneal shunt insertion was used, which immediately controlled the effusion. A shunt study was performed shortly after hospital discharge, which showed an occluded Denver shunt and a patent LeVeen shunt. The patient succumbed to metastatic carcinoma 18 months after discharge, but no pleural effusion had recurred.

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Citations

Nov 16, 2010·Respirology : Official Journal of the Asian Pacific Society of Respirology·Jay H RyuFabien Maldonado
Jun 22, 2011·Annals of Internal Medicine·Angelo M Taveira-DaSilvaJoel Moss
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Apr 11, 2017·Journal of Medical Case Reports·Jonggeun LeeYeong Dae Kim
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Jul 10, 2019·Investigative Radiology·Claus Christian PieperMaxim Itkin
Dec 28, 2017·Journal of Nippon Medical School = Nippon Ika Daigaku Zasshi·Takeshi ShimakawaTakao Katsube
Dec 18, 2013·Deutsches Ärzteblatt International·Hans H SchildJörg Kalff

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