A EUROPEAN SURVEY ON THE TREATMENT OF ASCITES IN CIRRHOSIS

A questionnaire to assess the clinical choice of ascites treatment in cirrhosis was distributed to 1473 participants in an EASL meeting. The response rate (295, 20%) was considered satisfactory in view of the h eterogeneity of the persons attending this event. Most participants (8 6.4%) in the survey were hepatologists and gastroenterologists. The fo llowing conclusions of the survey are noteworthy: (1) The objective of ascites therapy was to eliminate completely or almost completely the ascitic fluid for 49% of responders and to decrease ascites volume to an acceptable level of patient comfort for 48%; (2) The classical prog ressive therapeutic schedule of ascites is rarely used; (3) Following mobilisation of ascites, most (82%) maintain patients on diuretic ther apy to avoid reaccumulation of ascites; (4) Only 5% of participants di d not use paracentesis to manage ascites in cirrhosis. This was the th erapeutic procedure most frequently used for patients with refractory ascites; (5) Although the most acceptable definition of refractory asc ites was ascites which cannot be mobilized by maximal medical treatmen t, a significant proportion of participants also considered that intra ctable ascites due to diuretic-induced complications and recidivant as cites should be included in the definition; (6) The proportions of par ticipants prescribing prophylactic therapy, mainly low sodium diet, to compensated patients with and without a past history of ascites were 68% and 16%, respectively. (C) Journal of Hepatology.