Thoracoscopy for diagnosis and management of refractory hepatic hydrothorax

• Published in: Chinese medical journal Vol. 119; no. 5; pp. 430 - 434
• Main Authors: Lin, Dian-jie, Zhang, Min, Gao, Gui-xin, Li, Bin, Wang, Mao-fen, Zhu, Ling, Xue, Li-fu
• Format: Journal Article
• Language: English
• Published: China Department of Respiratory Diseases, Shandong University Shandong Provincial Hospital, Jinan 250002, China 05.03.2006
• Subjects: Adult; Female; Humans; Hydrothorax - diagnosis; Hydrothorax - etiology; Hydrothorax - therapy; Liver Cirrhosis - complications; Male; Middle Aged; Talc - therapeutic use; Thoracoscopy - methods; 肝疾病; 胸腹水; 腹腔镜检查; hepatic hydrothorax; thoracoscopy; talc poudrage; pleurodesis
• ISSN: 0366-6999; 2542-5641
• DOI: 10.1097/00029330-200603010-00016

The prevalence of pleural effusion caused by hepatocirrhosis ranges from 0.4% to 30%. Some patients with hepatic hydrothorax （HH） fail to respond to aggressive medical management such as albumin application, diuretics, and thoracentesis, and remain refractory massive pleural fluid. The repeated suctions to relieve the symptoms such as respiratory distress are associated with significant hyponatremia and hypoalbuminemia caused by the large volumes of fluid loss. Review of the literature has revealed that, to date, no therapy is ideal. This report describes our experiments in treating HH of patients with cirrhosis and ascites by thoracoscopy and talc poudrage, to offer our efforts to approach the pathogenesis of HH and to explore the new therapeutic strategy.