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Dipin Gupta
Valentino Piacentino, III
James B. McClurken
Satoshi Furukawa
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Ann Thorac Surg 2004;78:e9-e12
© 2004 The Society of Thoracic Surgeons

Case report

Use of LeVeen pleuroperitoneal shunt for refractory high-volume chylothorax

Dipin Gupta, MDa, Kerry Ross, BSa, Valentino Piacentino, III, PhDb, Dawn Stepnowski, CRNPa, James B. McClurken, MDb, Satoshi Furukawa, MDb, Daniel T. Dempsey, MD*a

a Department of Surgery, Philadelphia, Pennsylvania, USA
b Division of Cardiac and Thoracic Surgery, Temple University School of Medicine, Philadelphia, Pennsylvania, USA

Accepted for publication December 12, 2003.

* Address reprint requests to Dr Dempsey, Department of Surgery, Temple University School of Medicine, 3401 N Broad St, Philadelphia, PA 19140, USA
e-mail: daniel.dempsey{at}temple.edu

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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[Abstract] [Full Text] [PDF]


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