The contemporary management of chyle leak following cervical thoracic duct damage

The considerable anatomical variation of the thin walled cervical thoracic duct predisposes it to inadvertent damage during neck dissection. If this is not recognised at the time of surgery, a chyle leak can result in potentially serious complications as well as delaying the patient's discharge from hospital. This article summarises the basic anatomy of the terminal thoracic duct in the neck and discusses the pathophysiology of a chyle leak. We present the latest ideas for managing this problem when it is identified at the time of surgery, and review the diagnosis and contemporary management options available for dealing with this difficult problem when it is found to occur post-operatively.