Risk of complications after abdominal paracentesis in cirrhotic patients: a prospective study

Clin Gastroenterol Hepatol. 2009 Aug;7(8):906-9. doi: 10.1016/j.cgh.2009.05.004. Epub 2009 May 15.

Abstract

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 10(9)/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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Ascites / therapy*
  • Humans
  • Liver Cirrhosis / complications*
  • Liver Cirrhosis / therapy
  • Middle Aged
  • Paracentesis / adverse effects*
  • Platelet Count
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Postoperative Complications / mortality
  • Prospective Studies
  • Risk Factors*
  • Severity of Illness Index