Yang JX, Peng YM, Zeng HT, Lin XM, Xu ZL. Drainage of ascites in cirrhosis. World J Hepatol 2024; 16(9): 1245-1257 [PMID: 39351514 DOI: 10.4254/wjh.v16.i9.1245]
Corresponding Author of This Article
Zheng-Lei Xu, MD, Assistant Professor, Chief Doctor, Department of Gastroenterology, Shenzhen People’s Hospital, The Second Clinical Medical College, Jinan University, No. 1017 Dongmen North Road, Shenzhen 518000, Guangdong Province, China. 78249073@qq.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jia-Xing Yang, Hao-Tian Zeng, Xi-Min Lin, Department of Gastroenterology, The Second Clinical Medical College, Jinan University, Shenzhen 518000, Guangdong Province, China
Yue-Ming Peng, Department of Nursing, Shenzhen People’s Hospital, The Second Clinical Medical College, Jinan University, Shenzhen 518000, Guangdong Province, China
Zheng-Lei Xu, Department of Gastroenterology, Shenzhen People’s Hospital, The Second Clinical Medical College, Jinan University, Shenzhen 518000, Guangdong Province, China
Co-first authors: Jia-Xing Yang and Yue-Ming Peng.
Author contributions: Yang JX and Peng YM contributed equally to this work; Yang JX, Zeng HT, Lin XM, Xu ZL wrote the manuscript; All authors have read and approved the final manuscript.
Supported bySanming Project of Medicine in Shenzhen, No. SZSM202211029.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zheng-Lei Xu, MD, Assistant Professor, Chief Doctor, Department of Gastroenterology, Shenzhen People’s Hospital, The Second Clinical Medical College, Jinan University, No. 1017 Dongmen North Road, Shenzhen 518000, Guangdong Province, China. 78249073@qq.com
Received: July 3, 2024 Revised: July 20, 2024 Accepted: July 29, 2024 Published online: September 27, 2024 Processing time: 82 Days and 7.7 Hours
Abstract
For cirrhotic refractory ascites, diuretics combined with albumin and vasoactive drugs are the first-line choice for ascites management. However, their therapeutic effects are limited, and most refractory ascites do not respond to medication treatment, necessitating consideration of drainage or surgical interventions. Consequently, numerous drainage methods for cirrhotic ascites have emerged, including large-volume paracentesis, transjugular intrahepatic portosystemic shunt, peritoneovenous shunt, automated low-flow ascites pump, cell-free and concentrated ascites reinfusion therapy, and peritoneal catheter drainage. This review introduces the advantages and disadvantages of these methods in different aspects, as well as indications and contraindications for this disease.
Core Tip: For cirrhotic refractory ascites, peritoneovenous shunt is rarely used due to its high complication rate. Initial treatment for most refractory ascites prioritizes large-volume paracentesis combined with albumin infusion and peritoneal catheter drainage. If these treatments are ineffective or result in severe complications, transjugular intrahepatic portosystemic shunt or automated low-flow ascites pump may be considered. Cell-free and concentrated ascites reinfusion therapy requires further validation for suitability.
