International survey among hepatologists and pulmonologists on the hepatic hydrothorax: plea for recommendations.
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Cadranel Jean-François David, Ollivier-Hourmand Isabelle, Cadranel Jacques, Thevenot Thierry, Zougmore Honoré, Nguyen-Khac Eric, Bureau Christophe, Allaire Manon, Nousbaum Jean-Baptiste, Loustaud-Ratti Véronique, Causse Xavier, Sogni Philippe, Hanslik Bertrand, Bourliere Marc, Peron Jean-Marie, Ganne-Carrie Nathalie, Dao Thong, Thabut Dominique, Maitre Bernard, Debzi Nabil, Smadhi Ryad, Sombie Roger, Kpossou Raimi, Nouel Olivier, Bissonnette Julien, Ruiz Isaac, Medmoun Mourad, Dastis Sergio Negrin, Deltenre Pierre, Artru Florent, Raherison Chantal, Elkrief Laure, Lemagoarou Tristan
Аннотация
METHODS: Practitioners from 13 French- speaking countries were invited to answer an online questionnaire on the hepatic hydrothorax diagnosis and its management.
RESULTS: Five hundred twenty-eight practitioners (80% from France) responded to this survey. 75% were hepatogastroenterologists, 20% pulmonologists and the remaining 5% belonged to other specialities. The Hepatic hydrothorax can be located on the left lung for 64% of the responders (66% hepatogastroenterologists vs 57% pulmonologists; p = 0.25); The Hepatic hydrothorax can exist in the absence of clinical ascites for 91% of the responders (93% hepatogastroenterologists vs 88% pulmonologists; p = 0.27). An Ultrasound pleural scanning was systematically performed before a puncture for 43% of the responders (36% hepatogastroenterologists vs 70% pulmonologists; p < 0.001). A chest X-ray was performed before a puncture for 73% of the respondeurs (79% hepatogastroenterologists vs 54% pulmonologists; p < 0.001). In case of a spontaneous bacterial empyema, an albumin infusion was used by 73% hepatogastroenterologists and 20% pulmonologists (p < 0.001). A drain was used by 37% of the responders (37% hepatogastroenterologists vs 31% pulmonologists; p = 0.26).An Indwelling pleural catheter was used by 50% pulmonologists and 22% hepatogastroenterologists (p < 0.01). TIPS was recommended by 78% of the responders (85% hepatogastroenterologists vs 52% pulmonologists; p < 0.001) and a liver transplantation, by 76% of the responders (86% hepatogastroenterologists vs 44% pulmonologists; p < 0.001).
CONCLUSIONS: The results of this large study provide important data on practices of French speaking hepatogastroenterologists and pulmonologists; it appears that recommendations are warranted.