Risk of Complications After Abdominal Paracentesis in Cirrhotic Patients: A Prospective Study
published online 18 May 2009.
Background & Aims
Complications and technical problems of paracentesis in cirrhotic patients are infrequent. However, the severity and the incidence of these events and their risk factors have not been assessed prospectively.
Methods
Cirrhotic patients (n = 171) undergoing paracentesis were included. Of the 515 paracenteses, 8.8% were diagnostic, and 91.2% were therapeutic. Technical features, demographic data, and adverse events during a period of 72 hours after the procedure were examined.
Results
Major complications occurred in 1.6% of procedures and included 5 bleedings and 3 infections, resulting in death in 2 cases. Major complications were associated with therapeutic but not diagnostic procedures and tended to be more prevalent in patients with low platelet count (<50 109/L), Child-Pugh stage C, and in alcoholic cirrhosis patients. Technical problems occurred in 5.6%. The most frequent complication was a leak of ascites at the puncture site (5.0%), and in 89.5% there were no complications.
Conclusions
The safety of paracentesis in cirrhotic patients might be decreased if risk factors, which depend on the characteristics of the patient and of the procedure itself, are present.
⁎Division of Gastroenterology and Hepatology, University Hospital of Geneva, Geneva, Switzerland
‡Division of Hepatology, Hôpital Jean Minjoz, Besançon, France
§Laboratory of Biostatistics and Epidemiology (Universitat Autònoma de Barcelona) and Clinical Pharmacology (Hospital Clínic), Barcelona, Spain
Reprint requests Address requests for reprints to: Dr Andrea De Gottardi, Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clínic, Villarroel 170, 08036 Barcelona, Spain. fax: (34) 93-227-93-48
Conflicts of interest The authors disclose no conflicts.
Funding A.D.G. is supported by a Sheila Sherlock Fellowship from the European Association for the Study of the Liver and by the Swiss Foundation for Grants in Biology and Medicine.
ABSTRACT
Risk of Complications After Abdominal Paracentesis in Cirrhotic Patients: A Prospective Study