LAPAROSCOPIC ULTRASOUND-GUIDED DRAINAGE OF LYMPHOCELES FOLLOWING RENAL-TRANSPLANTATION

The development of a lymphocele is an uncommon but well-documented com plication of renal transplantation. In most patients, lymphoceles rema in asymptomatic, and no intervention is required. In some cases, howev er, lymphoceles become symptomatic and cause systemic and local manife stations. Ultrasonic scanning can easily diagnose and locate the size and position of perirenal fluid collections. Many of these patients ca n be managed conservatively by aspiration and drainage of the lymphoce le under radiologic guidance. However, if the lymphocele remains sympt omatic or reaccumulates after aspiration and drainage, surgical interv ention may be required. We describe two different ultrasound-guided la paroscopic techniques for drainage of a perirenal lymphocele into the peritoneal cavity. Successful drainage was accomplished in 5 patients, with 1 patient suffering an injury to the ureter of the transplant ki dney. Recommendations regarding patient selection and operative techni que are presented.