Aug 16, 2022
Contributor: Aaron Lessen, MD
Educational Pearls:
- Patients with recurrent ascites may need frequent outpatient or emergency department paracentesis which can be time consuming and uncomfortable for patients.
- Tunneled peritoneal catheters are a permanent alternative therapy which allows fluid drainage at home by patient or caregiver.
- There has been theoretical concern that long term placement of tunneled peritoneal catheters may increase risk of infection, thus they are more commonly placed as a palliative measure for patients with end stage cancer and malignant ascites with shorter anticipated life spans.
- However, a recent small study found that in both patients with malignant ascites and recurrent ascites from cirrhosis, tunneled peritoneal catheter placement reduced symptoms from ascites and did not increase risk of infection or leakage at catheter site, or spontaneous bacterial peritonitis after four weeks. More research is emerging and tunneled peritoneal catheters may become more common.
References
Kimer N, Riedel AN, Hobolth L,
et al. Tunneled Peritoneal Catheter for Refractory Ascites in
Cirrhosis: A Randomized Case-Series. Medicina (Kaunas). 2020;56(11):565. Published 2020 Oct 27.
doi:10.3390/medicina56110565
Petzold G, Bremer SCB, Heuschert FC, et al.
Tunnelled Peritoneal Catheter for Malignant Ascites-An Open-Label,
Prospective, Observational Trial. Cancers (Basel). 2021;13(12):2926. Published 2021 Jun 11.
doi:10.3390/cancers13122926
Corrigan M, Thomas R, McDonagh J, et al.
Tunnelled peritoneal drainage catheter placement for the palliative
management of refractory ascites in patients with liver
cirrhosis. Frontline
Gastroenterol.
2020;12(2):108-112. Published 2020 Feb 28.
doi:10.1136/flgastro-2019-101332
Summarized by Kirsten Hughes, MS4 | Edited by John Spartz, MD & Erik Verzemnieks, MD
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