The management of chylothorax remained a subject of academic interest until 1948 when Lampson13 performed the first successful transthoracic ligation of the thoracic duct for the cure of a traumatic chylothorax. Before this time the mortality rate for chylothorax was 50%.8 The recent marked increase in surgery for diseases of the heart and adjacent great vessels coupled with a general increase in surgery for other intrathoracic structures has transformed chylothorax into a relatively common complication. The purpose of this paper is to report the complications associated with the author's (W. H. F.)5-7 technique for bilateral thoracic duct cannulation and to set forth the various types of management. Materials and Methods Since early in 1961 on the Thoracic Surgical Service B, all patients suspected of having a malignant lesion, particularly of the lung, have been subjected to a bilateral scalene lymph node excision and bilateral thoracic duct cannulation.