Safety and effectiveness of transient ascites drainage in hospitalized patients with large ascites

Single paracentesis is the standard treatment for large ascites. An alternative is the placement of a transient ascites drainage. This study aimed to evaluate the efficacy and safety of transient ascites drainage in patients with large ascites.

Patients with symptomatic ascites who underwent transient ascites drainage between January 2017 and February 2022 were enrolled in this study. The amount of drained ascites and the duration of the drainage stay were recorded. Drainage-associated acute complications have been documented. Risk factors for complications were analyzed.

A total of 224 ascites drains were inserted into 177 patients. The mean cumulative volume of drained ascites was 14 284 ml (±9987). The duration of drainage varied between 0 and 42 days and averaged 8.57 days (±6.51). The technical success rate of drain placement was 98.21% (220/224). The most common drainage-associated complications were acute kidney injury in 31/224 (13.84%), bacterial peritonitis 16/185 (8.65%), and drainage-associated fistula [21/224 (9.38%)]. There were significant differences between the groups with and without drainage-associated peritonitis in the duration of drainage stay [13.63 (±8.13) vs. 8.06 (±6.20) days; P  = 0.001). The frequency of peritonitis with a length of drainage stay of up to 7 days was 1.92%, with a length of stay greater than 7 days 17.28% ( P  < 0.001).

Transient ascites catheters are effective for the drainage of large-volume ascites. The technical success rate was high, and the procedure itself was safe; however, owing to the high rate of drainage-associated peritonitis, a longer duration of drainage should be avoided.