Tunneled Peritoneal Catheter for Refractory Ascites in Cirrhosis: A Randomized Case-Series

Overview

Journal Medicina (Kaunas)

Publisher MDPI

Specialty General Medicine

Date 2020 Oct 30

PMID 33121063

Citations 1

Authors

Nina Kimer

Agnete Nordheim Riedel

Lise Hobolth

Christian Mortensen

Lone Galmstrup Madsen

Mette Lehmann Andersen

Frank Vinholdt Schiodt

Soren Moller

Lise Lotte Gluud

Affiliations

Soon will be listed here.

Abstract

Background And Objectives: Refractory ascites markedly worsens prognosis in cirrhosis. Large volume paracentesis (LVP) is standard treatment, but complications are common. In a randomized controlled case-series, we assessed a permanent tunneled peritoneal catheter versus LVP in patients with cirrhosis and ascites.

Materials And Methods: Random allocation was computer-generated, and concealment used opaque envelopes. Patients were included from January 2017 to December 2018. Inclusion criteria were cirrhosis and recurrent ascites and expected survival of more than 3 months.

Results: Thirteen patients were enrolled (PleurX =6 versus LVP = 7). Seven were female, ranging in age from 51 to 80 years. No procedure-related complications occurred. Two patients died due to variceal bleeding (PleurX-group) and sepsis (LVP-group). One patient was withdrawn due to hyponatremia (PleurX-group). Two patients were withdrawn due to bacterial peritonitis and infection of unknown origin (control-group). In the PleurX-group, all patients colonized the catheter, two developed bacterial peritonitis. The most common bacterial colonization was ( = 4).

Conclusions: In selected patients, the PleurX catheter mobilizes ascites and may be an alternative to LVP. The risk of infection should be considered in each case. The impact of colonization and risk of infections needs further investigation. The present trial does not allow for statistical conclusions.

Citing Articles

Palliative long-term abdominal drains for the management of refractory ascites due to cirrhosis: a consensus document.

Macken L, Corrigan M, Prentice W, Finlay F, McDonagh J, Rajoriya N Frontline Gastroenterol. 2022; 13(e1):e116-e125.

PMID: 35812034 PMC: 9234735. DOI: 10.1136/flgastro-2022-102128.

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