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Author Spotlight: Advancements in Retroperitoneal Approach for Necrotizing Pancreatitis
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Optimal management of ascites.

Marika Rudler1, Maxime Mallet1, Philippe Sultanik1

  • 1Intensive Care Unit, Hepatology Department, Pitié-Salpêtrière Hospital, Paris, France.

Liver International : Official Journal of the International Association for the Study of the Liver
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PubMed
Summary

Ascites, a common cirrhosis complication, requires management via diet, diuretics, or paracentesis. For refractory cases, advanced therapies like TIPS, transplantation, albumin infusions, or Alfapump® offer new treatment avenues.

Keywords:
ascitescirrhosisportal hypertension

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Area of Science:

  • Hepatology
  • Gastroenterology

Background:

  • Ascites is the most frequent complication of cirrhosis.
  • It affects 5%-10% of patients annually, significantly impacting quality of life and survival.
  • Current management includes sodium restriction, diuretics, and paracentesis, alongside treating the underlying liver disease.

Purpose of the Study:

  • To review current therapeutic options for ascites management.
  • To analyze data on established and emerging treatments for ascites.
  • To propose a decision-making algorithm for physicians treating ascites.

Main Methods:

  • Review of current data on ascites management options.
  • Analysis of established therapies (diet, diuretics, paracentesis, TIPS, transplantation).
  • Evaluation of newer therapies including albumin infusions and Alfapump®.

Main Results:

  • Standard medical therapies are the first line for ascites.
  • Transjugular intrahepatic portosystemic shunt (TIPS) and liver transplantation are options for refractory ascites.
  • Albumin infusions and Alfapump® represent emerging therapeutic strategies.

Conclusions:

  • Effective ascites management is crucial for improving patient outcomes.
  • A stepwise approach considering patient condition and treatment efficacy is necessary.
  • The review provides an algorithm to guide clinical decisions in complex ascites cases.