Pleural Effusion After Right Hepatectomy: What to Expect - Pulmonology

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After undergoing a right hepatectomy for hepatocellular carcinoma (HCC), it is not uncommon for patients to experience pleural effusion, which is the accumulation of fluid in the pleural space surrounding the lungs. In your case, the ultrasound revealed approximately 1000 mL of pleural effusion one month post-surgery. While it is reassuring that you are not experiencing significant discomfort aside from mild shortness of breath, the volume of fluid noted is indeed on the higher side for this time frame.

Pleural effusion can occur for several reasons following abdominal surgery, including inflammation, irritation of the pleura, or even post-operative complications such as infection or fluid overload. The presence of fluid can lead to symptoms such as dyspnea (shortness of breath), especially when the volume is substantial enough to compress lung tissue.

In many cases, pleural effusions can resolve spontaneously over time as the body reabsorbs the fluid. The rate of absorption can vary significantly among individuals, depending on factors such as the underlying cause of the effusion, the patient's overall health, and any concurrent medical conditions. Generally, small to moderate effusions may resolve within a few weeks to months. However, larger effusions, such as the one you are experiencing, may take longer to resolve and could require medical intervention if they do not improve.

Given that you have no history of liver cirrhosis and your albumin level is normal (4.5 g/dL), your liver function appears stable, which is a positive sign. However, it is essential to monitor the effusion closely. I recommend following up with your primary surgeon or a pulmonologist to assess the situation further. They may suggest imaging studies, such as a chest X-ray or CT scan, to evaluate the effusion's size and characteristics. If the effusion persists or worsens, therapeutic options such as thoracentesis (a procedure to drain excess fluid) may be considered to relieve symptoms and analyze the fluid for any underlying pathology.

In summary, while it is possible that the pleural effusion may gradually resolve on its own, it is crucial to maintain regular follow-up with your healthcare provider to monitor your condition. They can provide guidance on the appropriate next steps, including potential interventions if the effusion does not improve or if your symptoms escalate. Your health and comfort are paramount, so do not hesitate to seek medical advice if you have concerns about your recovery.