• Abdul Nadir
  • David H Van Thiel


Background: Ascites is a common clinical manifestation of advanced liver disease which can bemanaged with repeated large volume paracentesis. We sought to determine if continuous paracentesis viaplacement of an indwelling catheter for the management of ascites is safe and effective. Methods: Weplaced 38 peritoneal drainage catheters in 30 patients for durations ranging from 1–10 days. Patientsunderwent ascites fluid culture and cell count determinations immediately before and after the completionof paracentesis. Serum WBC count, BUN and creatinine levels were available on all patients before andafter paracentesis. The descriptive data were analysed to assess the rate of peritoneal infections, change inrenal function and ultimate clinical outcome of patients. Results: A mean 12.73 litres of peritoneal fluidwas removed via continuous peritoneal drainage accomplished with the use of an indwelling abdominalcatheter. Eight peritoneal cultures obtained after paracentesis grew out. The mean peritoneal cell countbefore and after paracentesis in each subject did not show evidence for spontaneous bacterial peritonitis.Five patients underwent successful liver transplantation (OLTX) and did not develop any peritonealinfections post OLTX. Conclusion: Continuous large volume paracentesis using an indwellingabdominalcatheter for several days is effective in removing large volumes of peritoneal fluid in patients with endstage-liver-disease (ESLD). The peritoneal fluid can grow out bacteria if it is left in the abdomen for ≥3days.Keywords: Large volume Paracentesis, indwelling


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