P0202 : Placement of a permanent, tunnelled peritoneal drainage catheter (PleurX) for refractory malignant and portal-hypertensive ascites in a multicentre study

Semadeni, Gian-Marco; Gubler, Christoph; Nagy, Alina; Manser, Christine N.; Borovicka, Jan; Semela, David

doi:10.1016/s0168-8278(15)30421-9

Cited by 2 publications

(23 citation statements)

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“…Overall patient survival was limited, as expected in all aetiologies of RA. Where reported, median survival in ESLD varied between 29 days to 6 months, consistent with known median survival in this group . Median PIPC survival in ESLD ranged between 6 weeks to 5 months, in‐keeping with mean PleurX™ catheter survival in the malignant ascites NICE technology appraisal …”

Section: Resultssupporting

confidence: 78%

“…Catheters were inserted by interventional nephrologists in two studies, one stating under ultrasound and fluoroscopic guidance . In a further two, catheters were inserted by consultant physicians/gastroenterologists under ultrasound guidance . Two studies did not report on insertion methods; one study reported catheters were inserted by trained physicians using X‐ray guidance, and one drainage catheter was inserted surgically (Tenckhoff catheter) (Table ).…”

Section: Resultsmentioning

confidence: 99%

“…Cephalosporins were used for peri‐procedural prophylaxis in six studies, with one using Metronidazole in addition, two studies using peritoneal dialysis catheters used either Cefazolin or Vancomycin, and a further solely using Sulbactam/Ampicillin . In one study, two patients with cirrhosis were commenced on long term antibiotic prophylaxis following development and successful treatment of bacterial peritonitis (BP) . In these two cases, drainage catheters were not removed but left in situ throughout.…”

Section: Resultsmentioning

confidence: 99%

“…In one study, two patients with cirrhosis were commenced on long term antibiotic prophylaxis following development and successful treatment of bacterial peritonitis (BP) . In these two cases, drainage catheters were not removed but left in situ throughout. Four studies reported the use of long term antibiotic prophylaxis (Ciprofloxacin or Norfloxacin); in one, a case series, prophylaxis was only used in the final two patients after review of the initial five cases, a second used prophylaxis only if there was a history of prior spontaneous bacterial peritonitis (SBP) or according to EASL guidelines, a third not defining in which population prophylactic antibiotics were used .…”

Section: Resultsmentioning

confidence: 99%

“…Cellulitis at catheter insertion site was reported in nine of 147 (6%) patients with ESLD . Four mixed cohort studies reported 11 patients with either cellulitis or “local infection”; without stating underlying aetiology, therefore not included in analysis …”

Section: Resultsmentioning

confidence: 99%

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Permanent indwelling peritoneal catheters for palliation of refractory ascites in end‐stage liver disease: A systematic review

Macken

Hashim

Mason

et al. 2019

Liver International

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Background & Aims The incidence and mortality from end‐stage liver disease is increasing, with a minority eligible for liver transplantation. Ascites is the commonest complication of end‐stage liver disease and large volume paracentesis (LVP) the accepted management strategy where refractory to medical treatment. In malignant ascites, permanent indwelling peritoneal catheters (PIPC) are an established palliative intervention. The aims are to describe available data using permanent indwelling peritoneal catheters in refractory ascites due to end‐stage liver disease. Methods Using systematic review methodology, databases were searched (MEDLINE, EMBASE, CINAHL [The Cumulative Index to Nursing and Allied Health Literature], Google Scholar and Cochrane Database of Systematic Reviews from inception‐March 2018), for studies combining ascites and palliative care. Inclusion and exclusion criteria were applied to results. Results Following initial and updated searches, 225 studies were identified for full text review, 18 were eligible for final analysis. The studies displayed heterogeneity in design, reported on different indwelling catheters and were overall of low quality. Only one pilot randomised controlled trial was identified, of PIPC versus LVP, recruiting one patient into each arm. Technical insertion success was 100%, with low rates of non‐infectious complications (<12%), none life threatening. Rates of bacterial peritonitis were not unacceptably high (12.7%), considering this was an end‐stage liver disease population and only a minority utilising long‐term prophylactic antibiotics. Only one study attempted quality‐of‐life assessments; none addressed potential health economic benefits. Conclusions Despite lack of well‐designed studies, preliminary data suggests low significant complication rates; however safety and efficacy of permanent indwelling peritoneal catheters in end‐stage liver disease remains to be confirmed. Further prospective randomised controlled trials are warranted, potentially translating permanent indwelling peritoneal catheters into improved palliative care in end‐stage liver disease.

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Section: Resultssupporting

confidence: 78%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Permanent indwelling peritoneal catheters for palliation of refractory ascites in end‐stage liver disease: A systematic review

Macken

Hashim

Mason

et al. 2019

Liver International

View full text Add to dashboard Cite

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Palliative long-term abdominal drains in refractory ascites due to end-stage liver disease: A case series

et al. 2016

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Copyright and reuse:Sussex Research Online is a digital repository of the research output of the University.Copyright and all moral rights to the version of the paper presented here belong to the individual author(s) and/or other copyright owners. To the extent reasonable and practicable, the material made available in SRO has been checked for eligibility before being made available.Copies of full text items generally can be reproduced, displayed or performed and given to third parties in any format or medium for personal research or study, educational, or not-for-profit purposes without prior permission or charge, provided that the authors, title and full bibliographic details are credited, a hyperlink and/or URL is given for the original metadata page and the content is not changed in any way. MeSH headings/keywords

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P0202 : Placement of a permanent, tunnelled peritoneal drainage catheter (PleurX) for refractory malignant and portal-hypertensive ascites in a multicentre study

Cited by 2 publications

References 0 publications

Permanent indwelling peritoneal catheters for palliation of refractory ascites in end‐stage liver disease: A systematic review

Permanent indwelling peritoneal catheters for palliation of refractory ascites in end‐stage liver disease: A systematic review

Palliative long-term abdominal drains in refractory ascites due to end-stage liver disease: A case series

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