Laparoscopic treatment of symptomatic lymphoceles after kidney transplantation.

ABSTRACT

BACKGROUND: The incidence of lymphocele after kidney transplantation ranges from 0.6% to 18%. This study examines the use of laparoscopic ultrasound for the location of lymphoceles during laparoscopic drainage. METHODS: Between July 1993 and October 1998, we performed 147 kidney transplants. A symptomatic lymphocele was observed in 19 patients (12.9%). All of these patients underwent peritoneal laparoscopic fenestration of the lymphocele. The graft, kidney hilum, ureter, iliac vessels, and lymphoceles were 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 iliac 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 structures and decreases the risk of iatrogenic lesions.