Preoperative Fat Meals Improve Thoracic Duct Visualization in Surgery: Study
A new study published in the journal of BMC Surgery showed that eating meals high in fat before to surgery may improve the visibility of the cervical thoracic duct during reconstructive surgeries for thoracic duct obstruction, which might reduce the risk of surgical injuries and minimize operating periods.
Chylothorax, chylous ascites, and chylopericardium are examples of chylous leakage illnesses, which are a very rare but extremely complex group of clinical conditions that have long been a problem for the medical profession. As studies progress, there is evidence that thoracic duct (TD) outlet blockage and chylous leaking are significantly correlated.
According to earlier research, using olive oil during radical esophectomy can improve TD diagnosis or make preventive TD ligation easier. Therefore, this study was conducted in order to look into the safety and efficacy of giving patients a fat meal before surgery if they are having thoracic duct repair for chylous leaking brought on by blockage of the thoracic duct outlet.
A total of 18 individuals who had thoracic duct reconstruction between January 2022 and August 2024 and had been diagnosed with thoracic duct outlet blockage were the subjects of a retrospective research. Prior to surgery, patients were given a high-fat lunch.
The amount of time that passed between eating the high-fat meal and the thoracic duct being visible was noted. The thoracic duct's appearance, the length of the operation, and any damage to the thoracic duct or lymphatic branches were also noted.
Within 6 to 8 hours of the fat meal, the thoracic ducts of 11 individuals were revealed; 9 of these patients had a milky white thoracic duct. These patients had no damage to the thoracic duct or its branches, and the average surgery time was 126.82 ± 53.30 minutes.
Furthermore, only three individuals showed a milky white appearance of the thoracic duct, out of seven whose thoracic ducts were exposed more than eight hours after a fat meal.
2 patients had damage to the thoracic duct and its branches, and the average surgery time for these patients was 180.00 ± 48.31 minutes (P < 0.05). Following surgery to rebuild the thoracic duct, all patients experienced positive therapeutic results.
Overall, when performing reconstructive surgery for thoracic duct obstruction, preoperative fat meals seem to improve intraoperative visibility of the cervical portion of the thoracic duct, which may shorten operating times and lower the risk of iatrogenic thoracic duct injuries.
Source:
Jiang, Y., Yao, Z., Zhou, D., & Liu, Z. (2025). Application of fat meal in thoracic duct outlet obstruction reconstruction surgery. BMC Surgery, 25(1), 349. https://doi.org/10.1186/s12893-025-03113-2
