The laparoscopic management of post-transplant lymphocele: A critical review

W. Scott Melvin, G. L. Bumgardner, E. A. Davies, E. A. Elkhammas, M. L. Henry, R. M. Ferguson

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Background: The management of lymphocele in patients following kidney (KT) and kidney pancreas (KPT) transplants is evolving. Open surgery has been the traditional treatment, but some authors have advocated laparoscopic drainage in selected patients. Methods: We retrospectively reviewed our results in lymphocele treatment since developing a laparoscopic program at our institution. Results: Between May 1994 and June 1995, 186 KTs and 48 KPTs were performed, and 1,354 patients are currently being followed. Eight patients developed symptomatic lymphoceles an average of 26 months (range 4-59) following 6 KTs and 2 KPTs. All patients diagnosed were successfully drained laparoscopically, with no conversions to open surgery. Laparoscopic ultrasound was used to help with localization of the fluid collection. Operative time averaged 59 min, median hospital stay was 1 day (range 1-4), and there were no perioperative complications. Follow-up imaging was obtained on six patients, 3-16 months following their procedures, and no recurrences were noted. A review of the literature demonstrates a 5.3% rate of major complications and a 7% incidence of lymphocele recurrence. Conclusions: Intraoperative laparoscopic ultrasound can help localize fluid collections and prevent organ injuries. Laparoscopic drainage of lymphocele following transplantation results in minimal disability and an acceptable complication rate, although it is higher than with open drainage. Therefore, laparoscopic drainage should be considered as primary treatment for all patients with symptomatic post-transplant lymphocele.

Original languageEnglish (US)
Pages (from-to)245-248
Number of pages4
JournalSurgical Endoscopy
Volume11
Issue number3
StatePublished - Mar 1997
Externally publishedYes

Fingerprint

Lymphocele
Transplants
Drainage
Conversion to Open Surgery
Kidney
Recurrence
Operative Time
Pancreas
Length of Stay
Therapeutics
Transplantation
Incidence
Wounds and Injuries

Keywords

  • Laparoscopy
  • Lymphocele
  • Renal transplantation
  • Ureteral injury

ASJC Scopus subject areas

  • Surgery

Cite this

Melvin, W. S., Bumgardner, G. L., Davies, E. A., Elkhammas, E. A., Henry, M. L., & Ferguson, R. M. (1997). The laparoscopic management of post-transplant lymphocele: A critical review. Surgical Endoscopy, 11(3), 245-248.

The laparoscopic management of post-transplant lymphocele : A critical review. / Melvin, W. Scott; Bumgardner, G. L.; Davies, E. A.; Elkhammas, E. A.; Henry, M. L.; Ferguson, R. M.

In: Surgical Endoscopy, Vol. 11, No. 3, 03.1997, p. 245-248.

Research output: Contribution to journalArticle

Melvin, WS, Bumgardner, GL, Davies, EA, Elkhammas, EA, Henry, ML & Ferguson, RM 1997, 'The laparoscopic management of post-transplant lymphocele: A critical review', Surgical Endoscopy, vol. 11, no. 3, pp. 245-248.
Melvin WS, Bumgardner GL, Davies EA, Elkhammas EA, Henry ML, Ferguson RM. The laparoscopic management of post-transplant lymphocele: A critical review. Surgical Endoscopy. 1997 Mar;11(3):245-248.
Melvin, W. Scott ; Bumgardner, G. L. ; Davies, E. A. ; Elkhammas, E. A. ; Henry, M. L. ; Ferguson, R. M. / The laparoscopic management of post-transplant lymphocele : A critical review. In: Surgical Endoscopy. 1997 ; Vol. 11, No. 3. pp. 245-248.
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