Laparoscopic treatment of symptomatic lymphoceles after kidney transplantation

Background: The incidence of lymphocele after kidney transplantation ranges from 0.6% to 18%. This study examines the use of laparoscopic ultrasound f or the location of lymphoceles during laparoscopic drainage. Methods: Between July 1993 and October 1998, we per; formed 147 kidney tran splants. A symptomatic lymphocele was observed in 19 patients (12.9%). All of these patients underwent peritoneal laparoscopic fenestration of the lym phocele. The graft, kidney hilum, ureter, iliac vessels, and lymphoceles we re identified by laparoscopic ultrasound. Results: All but one patient were discharged within 24 h. One recurrence (5 .2%), which was successfully treated by laparoscopy, was observed at a mean follow-up of 15.5 months. We had one complication (5.2%)-a left hydrocele that occurred 2 days after drainage of a lymphocele located in the left ili ac fossa. Conclusions: Laparoscopic peritoneal drainage of posttransplant lymphoceles shares the well known advantages of laparoscopy. Furthermore, laparoscopic ultrasound is a useful tool that allows the recognition of anatomical stru ctures and decreases the risk of iatrogenic lesions.