• Nina Kimer, Agnete Nordheim Riedel, Lise Hobolth, Christian Mortensen, Lone Galmstrup Madsen, Mette Lehmann Andersen, Frank Vinholdt Schiødt, Søren Møller, and Lise Lotte Gluud.
• Gastro Unit, Medical Division, Hvidovre University Hospital, 2650 Hvidovre, Denmark.
• Medicina (Kaunas). 2020 Oct 27; 56 (11).

Background And ObjectivesRefractory 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 MethodsRandom 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.ResultsThirteen 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 One patient was withdrawn due to hyponatremia (PleurX-group). Two patients were withdrawn due to bacterial peritonitis and infection of unknown origin (control-group).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).ConclusionsIn 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.

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