The risks here are a guide; your own risk may vary. You should discuss the risks and benefits of surgery with your surgeon, especially if you are worried.
General risks of thoracic surgery apply to decortication.
The following are also risks of decortication:
Minor more common risks
Air leaking from the lung into the chest drain for a few days is common after lung surgery. Occasionally this lasts for longer, possibly weeks. A chest drain will need to be in place until this settles, you may be able to go home with the chest drain still in and come back for regular check-ups until the air leak settles.
Your kidneys may not work as well after surgery but this is usually temporary and gets better with extra fluid.
Major less common risks
Shortness of breath may severe enough to require help from a ventilator machine. This can be with a face mask with you fully awake. It may also be need via a tube in your windpipe with you under sedation. If you need help breathing via a tube for a long time it may be better to have a temporary tracheostomy. This is a tube put in through the neck which is removed once breathing improves.
Empyema itself has a risk of death that is 15 to 20 in 100. The risk of death from the operation is 2 in 100 nationally, so 98 in 100 people recover from the surgery.