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Bispebjerg Hospital - a part of Copenhagen University Hospital

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

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  • Nina Kimer
  • Agnete Nordheim Riedel
  • Lise Hobolth
  • Christian Mortensen
  • Lone Galmstrup Madsen
  • Mette Lehmann Andersen
  • Frank Vinholdt Schiødt
  • Søren Møller
  • Lise Lotte Gluud
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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 One patient was withdrawn due to hyponatremia (PleurX-group). Two patients were withdrawn due to bacterial peritonitis and infection of unknown origin (control-group).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 Staph. Epidermidis (n = 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.

Original languageEnglish
JournalMedicina (Kaunas, Lithuania)
Issue number11
Publication statusPublished - 27 Oct 2020

ID: 61235593