The efficacy and safety of drainage with abdominal catheterization in cirrhotic patients with large-volume ascites_Chinese Journal of Evidence-Based Medicine

Authors：

ZHOU Hui ^1,2 , YANG Shujuan ^1,3 , ZHU Li ¹ , REN Danfeng ¹ , LI Jianzhou ¹ , ZHANG Guoyu ¹ , YANG Yuan ¹ , LIU Jingfeng ¹ , ZHAO Yingren ¹ , CHEN Tianyan ¹ , QIAO Wen ⁴ ,  HE Yingli ¹

1. Division of Infectious Diseases, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061, P.R.China;
2. Affiliated Hospital of Weifang Medical University, Weifang, 261000, P.R.China;
3. Division of Hepatology Section II, The Eight of Hospital of Xi’an, Xi’an, 710061, P.R.China;
4. Division of Gastroenterology, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061, P.R.China;

Corresponding author：

HE Yingli, Email: heyingli2000@xjtu.edu.cn

Keywords：

Abdominal paracentesis; Abdominal catheterization; Cirrhosis; Ascites

DOI：

10.7507/1672-2531.201708106

Video：

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Objective To investigate the efficacy and safety of abdominal indwelling catheterization for the patients with large-volume ascites. Methods A total of 84 patients with liver cirrhosis complicated with large-volume ascites admitted in the first affiliated hospital of Xi’an Jiaotong University from January 2015 to December 2015 were retrospectively analyzed. Patients were divided into two groups, one was the puncture group and another was the catheterization group. The efficacy and safety were evaluated. Results Forty-four patients were enrolled in catheterization group, whereas forty patients were enrolled in puncture group. Symptoms associated with ascites had been eased and patients’ qualities of life had been improved in 2 weeks in each group. The tube fell out rate was 27.3% for patients in catheterization group. There was no operation related complications such as death, bleeding and intestinal perforation occurred. Either Child B stage or Child C stage, the dynamic changes of liver function and renal function in catheterization group were comparable to those in puncture group. No adverse event such as catheterization-related or puncture-related infection was observed. Conclusion Abdominal catheterization is effective and safe in management of large amount of ascites complicated with cirrhosis, however, the high rate of tube-fell-out should be paid more attention.

Citation： ZHOU Hui, YANG Shujuan, ZHU Li, REN Danfeng, LI Jianzhou, ZHANG Guoyu, YANG Yuan, LIU Jingfeng, ZHAO Yingren, CHEN Tianyan, QIAO Wen, HE Yingli. The efficacy and safety of drainage with abdominal catheterization in cirrhotic patients with large-volume ascites. Chinese Journal of Evidence-Based Medicine, 2017, 17(10): 1140-1144. doi: 10.7507/1672-2531.201708106 Copy

1.	汪月娥, 王霞, 熊茜, 等. FibroScan 诊断慢性乙型肝炎肝纤维化的系统评价. 中国循证医学杂志, 2015, 15(5): 529-536.0.
2.	Runyon BA, AASLD. Introduction to the revised american association for the study of liver diseases practice guideline management of adult patients with ascites due to cirrhosis 2012. Hepatology, 2013, 57(4): 1651-1653.
3.	Narayanan G, Pezeshkmehr A, Venkat S, et al. Safety and efficacy of the PleurX catheter for the treatment of malignant ascites. J Palliat Med, 2014, 17(8): 906-912.
4.	Barnett TD, Rubins J. Placement of a permanent tunneled peritoneal drainage catheter for palliation of malignant ascites: a simplified percutaneous approach. J Vasc Interv Radiol, 2002, 13(4): 379-383.
5.	Tapping CR, Ling L, Razack A. PleurX drain use in the management of malignant ascites: safety, complications, long-term patency and factors predictive of success. Br J Radiol, 2012, 85(1013): 623-628.
6.	张炜, 徐小平, 瞿章书, 等. 中心静脉导管每日引流法治疗 35 例难治性腹水. 中国肝脏病杂志电子版, 2009, 1(2): 17-23.0.
7.	Agah S, Tavakoli S, Nikbakht H, et al. Central venous pressure catheter for large-volume paracentesis in refractory ascites. Indian J Gastroenterol, 2014, 33(4): 310-315.
8.	Solbach P, Honer Zu Siederdissen C, Taubert R, et al. Home-based drainage of refractory ascites by a permanent-tunneled peritoneal catheter can safely replace large-volume paracentesis. Eur J Gastroenterol Hepatol, 2017, 29(5):539-546.
9.	Martin DK, Walayat S, Jinma R, et al. Large-volume paracentesis with indwelling peritoneal catheter and albumin infusion: a community hospital study. J Community Hosp Intern Med Perspect, 2016, 6(5): 32421.
10.	郑俊福, 蔡照华, 张鑫, 等. 降钙素原和外周血白细胞/血小板单独或联合检测对肝硬化合并细菌感染患者早期诊断的价值. 临床肝胆病杂志, 2015, 31(2): 209-213.0.
11.	Cho SY, Choi JH. Biomarkers of sepsis. Infect Chemother, 2014, 46(1): 1-12.
12.	Nadir A, Van Thiel DH. Frequency of peritoneal infections among patients undergoing continuous paracentesis with an indwelling catheter. J Ayub Med Coll Abbottabad, 2010, 22(1): 37-41.
13.	Doyle H, McNaughton A. Novice research: central venous access device care infections. Br J Nurs, 2014, 23(8): S35-41.
14.	De Gottardi A, Thevenot T, Spahr L, et al. Risk of complications after abdominal paracentesis in cirrhotic patients: a prospective study. Clin Gastroenterol Hepatol, 2009, 7(8): 906-909.
15.	Gotlieb WH, Feldman B, Feldman-Moran O, et al. Intraperitoneal pressures and clinical parameters of total paracentesis for palliation of symptomatic ascites in ovarian cancer. Gynecol Oncol, 1998, 71(3): 381-385.

1. 汪月娥, 王霞, 熊茜, 等. FibroScan 诊断慢性乙型肝炎肝纤维化的系统评价. 中国循证医学杂志, 2015, 15(5): 529-536.0.
2. Runyon BA, AASLD. Introduction to the revised american association for the study of liver diseases practice guideline management of adult patients with ascites due to cirrhosis 2012. Hepatology, 2013, 57(4): 1651-1653.
3. Narayanan G, Pezeshkmehr A, Venkat S, et al. Safety and efficacy of the PleurX catheter for the treatment of malignant ascites. J Palliat Med, 2014, 17(8): 906-912.
4. Barnett TD, Rubins J. Placement of a permanent tunneled peritoneal drainage catheter for palliation of malignant ascites: a simplified percutaneous approach. J Vasc Interv Radiol, 2002, 13(4): 379-383.
5. Tapping CR, Ling L, Razack A. PleurX drain use in the management of malignant ascites: safety, complications, long-term patency and factors predictive of success. Br J Radiol, 2012, 85(1013): 623-628.
6. 张炜, 徐小平, 瞿章书, 等. 中心静脉导管每日引流法治疗 35 例难治性腹水. 中国肝脏病杂志电子版, 2009, 1(2): 17-23.0.
7. Agah S, Tavakoli S, Nikbakht H, et al. Central venous pressure catheter for large-volume paracentesis in refractory ascites. Indian J Gastroenterol, 2014, 33(4): 310-315.
8. Solbach P, Honer Zu Siederdissen C, Taubert R, et al. Home-based drainage of refractory ascites by a permanent-tunneled peritoneal catheter can safely replace large-volume paracentesis. Eur J Gastroenterol Hepatol, 2017, 29(5):539-546.
9. Martin DK, Walayat S, Jinma R, et al. Large-volume paracentesis with indwelling peritoneal catheter and albumin infusion: a community hospital study. J Community Hosp Intern Med Perspect, 2016, 6(5): 32421.
10. 郑俊福, 蔡照华, 张鑫, 等. 降钙素原和外周血白细胞/血小板单独或联合检测对肝硬化合并细菌感染患者早期诊断的价值. 临床肝胆病杂志, 2015, 31(2): 209-213.0.
11. Cho SY, Choi JH. Biomarkers of sepsis. Infect Chemother, 2014, 46(1): 1-12.
12. Nadir A, Van Thiel DH. Frequency of peritoneal infections among patients undergoing continuous paracentesis with an indwelling catheter. J Ayub Med Coll Abbottabad, 2010, 22(1): 37-41.
13. Doyle H, McNaughton A. Novice research: central venous access device care infections. Br J Nurs, 2014, 23(8): S35-41.
14. De Gottardi A, Thevenot T, Spahr L, et al. Risk of complications after abdominal paracentesis in cirrhotic patients: a prospective study. Clin Gastroenterol Hepatol, 2009, 7(8): 906-909.
15. Gotlieb WH, Feldman B, Feldman-Moran O, et al. Intraperitoneal pressures and clinical parameters of total paracentesis for palliation of symptomatic ascites in ovarian cancer. Gynecol Oncol, 1998, 71(3): 381-385.

Chinese Journal of Evidence-Based Medicine

The efficacy and safety of drainage with abdominal catheterization in cirrhotic patients with large-volume ascites

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