title: [The value of thoracoscopy for diagnosis and management of refractory hepatic hydrothorax].
abstract: OBJECTIVE
  To study the value of thoracoscopy for diagnosis and management of refractory hepatic hydrothorax (HH).
  
  
  METHODS
  Twenty-six patients with refractory HH were enrolled in this study. Twenty-four of them underwent therapeutic thoracoscopy to achieve pleurodesis by application of talc poudrage.
  
  
  RESULTS
  Nineteen of the 26 patients had dilated chest wall veins, 6 had dilated azygos veins, and 16 had diaphragm blebs. Of the 24 patients who received pleurodesis via thoracoscope, 14 cases showed complete response, and 8 showed partial response. Mild chest pain and temperature elevation were the most complaints during or after the procedure. Liver function abnormalities were the most serious side effects after pleurodesis. During the follow-up period ranging from 6 months to 3 years, 1 patient died of upper gastrointestinal hemorrhage and encephalopathy in 1 month, 3 patients died of hemorrhage in 6, 12, 18 months respectively, and 1 case experienced recurrence in 18 months.
  
  
  CONCLUSIONS
  Defects in the diaphragm seemed to be the main cause for the development of HH. Pleurodesis achieved by thoracoscopy and talc poudrage was effective in the treatment of HH, but complications and impaired liver functions should be considered.
authors.affiliation: Department of Respiratory Disease, Shandong Province Hospital, Jinan 250021, China.
authors.forename: Dian-jie
authors.initials: DJ
authors.lastname: Lin
authors.forename: Mao-fen
authors.initials: MF
authors.lastname: Wang
authors.forename: Gui-xin
authors.initials: GX
authors.lastname: Gao
authors.forename: Bin
authors.initials: B
authors.lastname: Li
authors.forename: Li-li
authors.initials: LL
authors.lastname: Su
authors.forename: Ling
authors.initials: L
authors.lastname: Zhu
authors.forename: Feng
authors.initials: F
authors.lastname: Chen
authors.forename: Li-fu
authors.initials: LF
authors.lastname: Xue
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D013906:Thoracoscopy