Use of subcutaneous venous......

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Use of subcutaneous venous access ports to treat refractory ascites.

Rosenblum DI, Geisinger MA, Newman JS, Boden TM, Markowitz D,

D, Mullen KD.

Departments of Radiology (D.I.R., J.S.N., T.M.B., D.M., D.P.) and

Gastroenterology (K.D.M.), MetroHealth Medical Center.

To assess the feasibility of peritoneal ports for management of

patients with cirrhotic refractory ascites, 10 ports were placed in

nine patients for frequent outpatient paracentesis. Retrospective

review and telephone interviews were used to assess port performance.

Kaplan-Meier analysis revealed a median duration of port patency of

255 days. In 1,557 port days, four access problems prompted further

interventional evaluation. Three cases of bacterial peritonitis and

one catheter obstruction developed. The use of subcutaneous venous

access ports to allow control of ascites by nursing personnel is a

promising alternative for management of patients with refractory

ascites. Additional studies are needed to determine long-term

effectiveness and safety