Tunneled peritoneal catheter placement under sonographic and fluoroscopic guidance in the palliative treatment of malignant ascites

OBJECTIVE. We present a treatment for recurrent, symptomatic ascites in pat ients with malignant disease. This report summarizes our experience with pe rcutaneous tunneled peritoneal catheters in 24 patients. SUBJECTS AND METHODS. Of the 40 consecutive patients who presented with at least four therapeutic paracenteses in a 4-week period, 24 patients underwe nt the percutaneous tunneled procedure. All had malignant ascites. RESULTS. All 24 patients had successful insertion of a permanent tunneled p eritoneal drainage catheter. Eighteen were outpatients and six were inpatie nts. All patients were relieved of their clinical symptoms, including abdom inal distention and dyspnea, and were relieved of lower extremity discomfor t. The mean life span after catheter placement was 7.2 weeks. Twenty (83%) of the 24 patients were treated at home with their catheters in place. Thre e patients experienced minor complications from bacterial peritonitis, whic h responded to antibiotics. One patient had to have his catheter removed. CONCLUSION. Percutaneous placement of specialized tunneled catheters appear s to be a viable and safe technique in patients who have symptomatic ascite s that require frequent therapeutic paracentesis for relief of symptoms.