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Open AccessBrief Report

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

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Gastro Unit, Medical Division, Hvidovre University Hospital, 2650 Hvidovre, Denmark
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Novo Nordisk Foundation Center for Basic Metabolic Research, Bridge Translational Excellence Program, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen N, Denmark
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Department of Clinical Medicine, University Hospital Køge, 4600 Køge, Denmark
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Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen N, Denmark
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Department of Gastroenterology, University Hospital Herlev, 2630 Herlev, Denmark
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Abdominal Center K, University Hospital Bispebjerg, 2400 Copenhagen NV, Denmark
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Center of Functional and Diagnostic Imaging and Research, Department of Clinical and Nuclear Medicine, Amager-Hvidovre University Hospital, 2650 Hvidovre, Denmark
*
Author to whom correspondence should be addressed.
Medicina 2020, 56(11), 565; https://doi.org/10.3390/medicina56110565
Received: 1 October 2020 / Revised: 21 October 2020 / Accepted: 26 October 2020 / Published: 27 October 2020
(This article belongs to the Special Issue Clinical Research and Trials in Gastroenterology and Hepatology)
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. View Full-Text
Keywords: peritoneal catheter; PleurX; liver cirrhosis; refractory ascites; spontaneous bacterial peritonitis peritoneal catheter; PleurX; liver cirrhosis; refractory ascites; spontaneous bacterial peritonitis
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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.

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