An Academic Hospitalist-Run Outpatient Paracentesis Clinic.

Area of Science:

• Hepatology
• Gastroenterology
• Internal Medicine

Background:

• Large-volume paracentesis (LVP) often requires inpatient hospitalization, leading to resource strain.
• Ascites management is a common clinical challenge requiring efficient treatment strategies.

Purpose of the Study:

• To evaluate the safety and efficacy of an outpatient paracentesis clinic.
• To assess the impact of an outpatient clinic on hospitalizations and resource utilization.

Main Methods:

• Retrospective review of 506 LVPs performed on 82 patients over 74 months.
• Data collected included patient demographics, ascites etiology, volume removed, procedure time, complications, and ascitic fluid analysis.
• Clinic was part of a quality assurance initiative at the Veterans Affairs Pittsburgh Healthcare System.

Main Results:

• Mean volume removed was 7.9 L in a mean procedure time of 33.3 minutes.
• Minor complications included postprocedure hypotension (5 episodes) and abdominal wall hematoma (1 episode).
• Two cases of umbilical hernia incarceration required surgical repair; nearly all 506 procedures avoided inpatient admission.

Conclusions:

• An outpatient paracentesis clinic effectively manages large-volume ascites.
• This model safely minimizes hospitalizations and optimizes healthcare resource allocation.
• Academic hospitalist-led clinics can provide efficient and safe paracentesis services.