Few complications after paracentesis in patients with cirrhosis and refractory ascites

The relevance of needle type and ultrasound guidance in connection with complications and technical problems in paracentesis in cirrhotic patients has only been sparsely described. The aim of this study was to evaluate paracentesis in cirrhotic patients with refractory ascites, focusing on technique, complications, amount of ascites drained and prognosis.

This was a retrospective study based on 51 cirrhotic patients with refractory ascites undergoing paracentesis. A total of 209 paracenteses were performed using a pigtail catheter and an intravenous catheter. Ultrasound-guided puncture or no ultrasound-guided punctured were compared with regard to amount of drained ascites, technical problems and complications both immediate and within a week of the procedure. The impact of coagulopathy was also investigated.

12% immediate and 5% late complications occurred, most of which were minor. No significant differences in the frequency of complications were found when comparing a pigtail to an intravenous catheter (8% versus 21%, OR = 2.81 95% CI (0.86; 9.13)), nor did the amount of drained ascites differ significantly. Ultrasound guidance did not significantly decrease the frequency of complications (7% versus 9%, OR 1.34 95% CI (0.37; 4.84)). Coagulopathy did not significantly affect the risk of complications.

Paracentesis in patients with cirrhosis is associated with a low frequency of serious complications, regardless of the technique deployed. Although the material is of limited size, it appears that coagulopathy does not increase the risk of complications following this procedure.