RT Journal Article
SR Electronic
T1 Palliative long-term abdominal drains for the management of refractory ascites due to cirrhosis: a consensus document
JF Frontline Gastroenterology
JO Frontline Gastroenterol
FD BMJ Publishing Group Ltd
SP e116
OP e125
DO 10.1136/flgastro-2022-102128
VO 13
IS e1
A1 Macken, Lucia
A1 Corrigan, Margaret
A1 Prentice, Wendy
A1 Finlay, Fiona
A1 McDonagh, Joanne
A1 Rajoriya, Neil
A1 Salmon, Claire
A1 Donnelly, Mhairi
A1 Evans, Catherine
A1 Ganai, Bhaskar
A1 Bedlington, Joan
A1 Steer, Shani
A1 Wright, Mark
A1 Hudson, Ben
A1 Verma, Sumita
A1 
YR 2022
UL http://fg.bmj.com/content/13/e1/e116.abstract
AB Palliative care remains suboptimal in advanced cirrhosis, in part relating to a lack of evidence-based interventions. Ascites remains the most common cirrhosis complication resulting in hospitalisation. Many patients with refractory ascites are not candidates for liver transplantation or transjugular intrahepatic portosystemic shunt, and therefore, require recurrent palliative large volume paracentesis in hospital. We review the available evidence on use of palliative long-term abdominal drains in cirrhosis. Pending results of a national trial (REDUCe 2) and consistent with recently published national and American guidance, long-term abdominal drains cannot be regarded as standard of care in advanced cirrhosis. They should instead be considered only on a case-by-case basis, pending definitive evidence. This manuscript provides consensus to help standardise use of long-term abdominal drains in cirrhosis including patient selection and community management. Our ultimate aim remains to improve palliative care for this under researched and vulnerable cohort.