Preprint Brief Report Version 1 Preserved in Portico This version is not peer-reviewed

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

Version 1 : Received: 1 October 2020 / Approved: 2 October 2020 / Online: 2 October 2020 (10:39:07 CEST)

A peer-reviewed article of this Preprint also exists.

Kimer, N.; Riedel, A.N.; Hobolth, L.; Mortensen, C.; Madsen, L.G.; Andersen, M.L.; Schiødt, F.V.; Møller, S.; Gluud, L.L. Tunneled Peritoneal Catheter for Refractory Ascites in Cirrhosis: A Randomized Case-Series. Medicina 2020, 56, 565. Kimer, N.; Riedel, A.N.; Hobolth, L.; Mortensen, C.; Madsen, L.G.; Andersen, M.L.; Schiødt, F.V.; Møller, S.; Gluud, L.L. Tunneled Peritoneal Catheter for Refractory Ascites in Cirrhosis: A Randomized Case-Series. Medicina 2020, 56, 565.

Journal reference: Medicina 2020, 56, 565
DOI: 10.3390/medicina56110565

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 01-2017 to 12-2018. 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, age range 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 One patient was withdrawn due to hyponatremia (PleurX-group). Two patients were withdrawn due to bacterial peritonitis and infection of unknown origin (Control-group).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. Trial Registration: EudraCT: CIV-16-10-017324; clinicaltrials.gov: NCT 03027635; Scientific Ethics Committee journal no: H-1604179

Subject Areas

peritoneal catheter; PleurX, liver cirrhosis, refractory ascites, spontaneous bacterial peritonitis,

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