The Palliative Management of Refractory Cirrhotic Ascites Using the PleurX © Catheter

الملخص EN

Background.

Treatment options are limited for patients with refractory cirrhotic ascites (RCA).

As such, we assessed the safety and effectiveness of the PleurX catheter for RCA.

Methods.

A retrospective analysis was performed on all patients with RCA who have undergone insertion of the PleurX catheter between 2007 and 2014 at our clinic.

Results.

Thirty-three patients with RCA were included in the study; 4 patients were lost to follow-up.

All patients were still symptomatic despite bimonthly large volume paracentesis and were not candidates for TIPS or PV shunt.

Technical success was achieved in 100% of patients.

The median duration the catheter remained in situ was 117.5 days, with 95% CI of 48–182 days.

Drain patency was maintained in 90% of patients.

Microorganisms consistent with spontaneous bacterial peritonitis (SBP) from a catheter source were isolated in 38% of patients.

The median time to infection was 105 days, with 95% CI of 34–233 days.

All patients were treated for SBP successfully with antibiotics.

Conclusion.

Use of the PleurX catheter for the management of RCA carries a high risk for infection when the catheter remains in situ for more than 3 months but has an excellent patency rate and did not result in significant renal injury.