Reliability of Poirier's triangle in localizing the thoracic duct in the thorax

Purpose: Preemptive ligation of the thoracic duct (TD) is occasionally performed during cardiothoracic procedures to prevent chylothorax. Landmarks for localizing this structure are thus important to the surgeon during such procedures. One historically used area for identifying this structure in the thorax is Poirier's triangle. The present paper aimed to investigate the relationship of the TD to Poirier's triangle. Methods: We evaluated the use of this geometric area in localizing the TD in 35 adult cadavers. Results: Poirier's triangle was found in all specimens, but the TD was found within the confines of Poirier's triangle in only 17 specimens (45.7%). When not identified in Poirier's triangle, the regional TD was often (28.6%) seen in the interval between the proximal left subclavian and left common carotid arteries. Conclusions: These data may be of use to the surgeon when identifying the proximal TD within the thorax.