Role of Indwelling Pleural Catheters in acheiving spontaneous pleurodesis in Hepatic Hydrothorax - Pioneer Retrospective Study from a Tertiary care centre,India

Abstract

Introduction: Indwelling tunneled pleural catheters (IPCs) are commonly used in palliative treatment for Malignant pleural effusions.In recent days,usage of IPC is increased in benign causes of recurrent pleural effusions.

Aims and Objectives: The present study aimed to assess the role of indwelling pleural catheters in acheiving spontaneous pleurodesis in hepatic hydrothorax.

Methods: This study was a retrospective analysis of medical records of patients who underwent IPC insertion for hepatic hydrothorax with cirrhosis /decompensated liver disease from September 2014 to September 2019.

Results: 30 patients with hepatic hydrothorax were placed with indwelling pleural catheters. Almost all patients were male.26 IPC s(86.6%) were placed for right sided effusion,only 4(13.3%) were placed for left sided effusion. Spontaneous pleurodesis was achieved in 18 patients (60%) and IPCs were removed in these patients.Most of the patients(70%) who achieved spontaneous pleurodesis with IPC received at atleast one TIPS (Transjugular Intrahepatic porto systemic shunt)procedure.Mean time in which pleurodesis achieved was 120.8 days (range, 15-290 d). Thus TIPS procedure increases the success rate of pleurodesis with Indwelling pleural catheters in Hepatic Hydrothorax.

Conclusion: Thus Indwelling Pleural catheters are useful in patients with hepatic hydrothorax with refractory pleural effusion.It also improves the quality of life and alleviates dyspnoea in those patients. Our study is the first ever study done in India on the use of indwelling pleural catheters and its ability in acheiving spontaneous pleurodesis in Hepatic hydrothorax.