Podcast 805: Tunneled Peritoneal Catheter

<p><strong>Contributor: Aaron Lessen, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Patients with recurrent ascites may need frequent outpatient or emergency department paracentesis which can be time consuming and uncomfortable for patients. </span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Tunneled peritoneal catheters are a permanent alternative therapy which allows fluid drainage at home by patient or caregiver. </span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">There has been theoretical concern that long term placement of tunneled peritoneal catheters may increase risk of infection, thus they are more commonly placed as a palliative measure for patients with end stage cancer and malignant ascites with shorter anticipated life spans.</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">However, a recent small study found that in both patients with malignant ascites and recurrent ascites from cirrhosis, tunneled peritoneal catheter placement reduced symptoms from ascites and did not increase risk of infection or leakage at catheter site, or spontaneous bacterial peritonitis after four weeks. More research is emerging and tunneled peritoneal catheters may become more common.  </span></li> </ul> <p><strong>References</strong></p> <p><span style="font-weight: 400;">Kimer N, Riedel AN, Hobolth L, et al. Tunneled Peritoneal Catheter for Refractory Ascites in Cirrhosis: A Randomized Case-Series.</span> <em><span style= "font-weight: 400;">Medicina (Kaunas)</span></em><span style= "font-weight: 400;">. 2020;56(11):565. Published 2020 Oct 27. doi:10.3390/medicina56110565</span><span style= "font-weight: 400;"><br /></span><span style= "font-weight: 400;"><br /></span><span style= "font-weight: 400;">Petzold G, Bremer SCB, Heuschert FC, et al. Tunnelled Peritoneal Catheter for Malignant Ascites-An Open-Label