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Computerized Tomography-Guided Paracentesis: An Effective Alternative to Bedside Paracentesis?

Vinaya Gaduputi¹, Hassan Tariq¹, Chaitanya Chandrala¹

¹Department of Medicine, Bronx Lebanon Hospital Center, 1650 Selwyn Ave., Suite #10C, Bronx, NY 10457, USA.

Journal of Clinical Medicine Research

|January 17, 2017

Summary

Computerized tomography (CT)-guided paracentesis removes more fluid and extends the time between procedures for ascites patients compared to bedside paracentesis. This CT-guided method is a safe, effective, and cost-efficient alternative for managing decompensated cirrhosis.

Keywords:

Ascites in cirrhosis Bedside paracentesis CT-guided bedside paracentesis CT-guided paracentesis Complications of paracentesis Management of ascites Therapeutic paracentesis

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Published on: December 23, 2014

Area of Science:

Hepatology
Interventional Radiology
Gastroenterology

Background:

Ascites is a common cause of hospitalization in decompensated cirrhosis.
Paracentesis is a standard, low-risk procedure for ascites management.
Computerized tomography (CT)-guided paracentesis offers a potential alternative to traditional bedside paracentesis.

Purpose of the Study:

To compare the efficacy, safety, and cost-effectiveness of CT-guided paracentesis versus bedside paracentesis.
To evaluate fluid removal volume, length of stay, and readmission rates.
To assess the economic benefits of CT-guided paracentesis.

Main Methods:

Retrospective study of 546 patients with cirrhosis and ascites from 2002-2012.
Group I: CT-guided pigtail catheter insertion for fluid drainage.
Group II: Bedside paracentesis with physical or sonographic localization.
Statistical analysis included Fischer exact test and unpaired t-test.

Main Results:

CT-guided paracentesis removed a significantly higher volume of fluid (2.72 L vs. 1.94 L).
The interval between paracentesis procedures was significantly longer for the CT group (106.56 days vs. 25.57 days).
An inverse correlation was observed between fluid removed and hospital length of stay.

Conclusions:

CT-guided paracentesis with pigtail catheter insertion is clinically effective.
This method is a safe and cost-effective alternative to conventional bedside paracentesis.
CT-guided paracentesis improves patient management by reducing the frequency of interventions.