Evidence-based recommendations on percutaneous thoracic duct embolisation for persistent chyle leak. In this procedure, under general anaesthesia, ultrasound and X-rays are used to create an image of the thoracic duct and find the leak. Then, using a needle, a tube is inserted through the abdominal wall (percutaneous) and guided into the thoracic duct. Small metal coils and medical glue are inserted through the tube and used to plug the leak (embolisation). The aim is to stop the leak.
Is this guidance up to date?
Next review: 2026
Guidance development process
This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account, and specifically any special arrangements relating to the introduction of new interventional procedures. The guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties. Providers should ensure that governance structures are in place to review, authorise and monitor the introduction of new devices and procedures.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.