Thoracoscopy and talc poudrage in the management of hepatic hydrothorax

Chest. 2000 Jul;118(1):13-7. doi: 10.1378/chest.118.1.13.


Study objective: To determine indications, limitations, morbidity and mortality of surgical thoracoscopy for management of hepatic hydrothorax, a rare, but often recurrent, complication in cirrhotic patients.

Patients and methods: From May 1985 through May 1999, 10 men and 8 women, with a mean age of 57.6 years (range, 26 to 76 years), underwent 21 therapeutic thoracoscopies to achieve pleurodesis by application of talc.

Results: The procedure was effective in 10 of 21 procedures. There were four recurrences (19. 1%) that were retreated, with only one being successful. In this specific group, we detected high morbidity (57.1%) and mortality (38.9%) during the follow-up period of 3 months. Diaphragmatic defects were localized and closed five times (23.8%). Hospital stay was approximately 15 days (range, 5 to 41 days).

Conclusion: The procedure appears to be indicated for these fragile patients, especially when medical therapy fails. Immediate efficacy was 47.6%, increasing to 60% with videothoracoscopy and suture of the diaphragmatic defect. However, morbidity and mortality were high.

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Hydrothorax / etiology
  • Hydrothorax / mortality
  • Hydrothorax / therapy*
  • Liver Cirrhosis / complications
  • Male
  • Middle Aged
  • Pleurodesis*
  • Retrospective Studies
  • Survival Rate
  • Talc / administration & dosage*
  • Thoracic Surgery, Video-Assisted*
  • Treatment Outcome


  • Talc