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[Current status of treatment of refractory ascites in patients with liver cirrhosis]. 2016

J Shao, and L Zhang, and G H Han, and D M Fan
Department of Liver Disease and Digestive Interventional Radiology, Xijing Hospital of the Fourth Military Medical University, Xi'an 710032, China.

Ascites is a common clinical manifestation of cirrhotic portal hypertension, and about 60%-80% of cirrhotic patients develop the symptom of ascites within 10 years. Once ascites occurs, the 5-year survival rate is reduced from 80% to 50%. With the progression of liver diseases, approximately 5%-10% of patients with ascites develop refractory ascites, and the median survival time is only 6-12 months. This article reviews the definition and diagnosis of refractory ascites, evaluation of prognostic factors, and treatment regimens, including large-volume paracentesis combined with protein supplementation, transjugular intrahepatic portosystemic shunt, and liver transplantation.

UI MeSH Term Description Entries
D006975 Hypertension, Portal Abnormal increase of resistance to blood flow within the hepatic PORTAL SYSTEM, frequently seen in LIVER CIRRHOSIS and conditions with obstruction of the PORTAL VEIN. Cruveilhier-Baumgarten Disease,Cruveilhier-Baumgarten Syndrome,Cruveilhier Baumgarten Disease,Cruveilhier Baumgarten Syndrome,Disease, Cruveilhier-Baumgarten,Portal Hypertension,Portal Hypertensions,Syndrome, Cruveilhier-Baumgarten
D008103 Liver Cirrhosis Liver disease in which the normal microcirculation, the gross vascular anatomy, and the hepatic architecture have been variably destroyed and altered with fibrous septa surrounding regenerated or regenerating parenchymal nodules. Cirrhosis, Liver,Fibrosis, Liver,Hepatic Cirrhosis,Liver Fibrosis,Cirrhosis, Hepatic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001201 Ascites Accumulation or retention of free fluid within the peritoneal cavity.
D013995 Time The dimension of the physical universe which, at a given place, orders the sequence of events. (McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed) Effects, Long-Term,Effects, Longterm,Long-Term Effects,Longterm Effects,Effect, Long-Term,Effect, Longterm,Effects, Long Term,Long Term Effects,Long-Term Effect,Longterm Effect
D015996 Survival Rate The proportion of survivors in a group, e.g., of patients, studied and followed over a period, or the proportion of persons in a specified group alive at the beginning of a time interval who survive to the end of the interval. It is often studied using life table methods. Cumulative Survival Rate,Mean Survival Time,Cumulative Survival Rates,Mean Survival Times,Rate, Cumulative Survival,Rate, Survival,Rates, Cumulative Survival,Rates, Survival,Survival Rate, Cumulative,Survival Rates,Survival Rates, Cumulative,Survival Time, Mean,Survival Times, Mean,Time, Mean Survival,Times, Mean Survival
D016019 Survival Analysis A class of statistical procedures for estimating the survival function (function of time, starting with a population 100% well at a given time and providing the percentage of the population still well at later times). The survival analysis is then used for making inferences about the effects of treatments, prognostic factors, exposures, and other covariates on the function. Analysis, Survival,Analyses, Survival,Survival Analyses
D016031 Liver Transplantation The transference of a part of or an entire liver from one human or animal to another. Grafting, Liver,Hepatic Transplantation,Liver Transplant,Transplantation, Hepatic,Transplantation, Liver,Hepatic Transplantations,Liver Grafting,Liver Transplantations,Liver Transplants,Transplant, Liver
D019152 Paracentesis A procedure in which fluid is withdrawn from a body cavity or organ via a trocar and cannula, needle, or other hollow instrument. Centesis,Culdocentesis,Puncture and Aspiration,Puncture and Drainage,Aspiration and Puncture,Centeses,Culdocenteses,Drainage and Puncture,Paracenteses
D019168 Portasystemic Shunt, Transjugular Intrahepatic A type of surgical portasystemic shunt to reduce portal hypertension with associated complications of esophageal varices and ascites. It is performed percutaneously through the jugular vein and involves the creation of an intrahepatic shunt between the hepatic vein and portal vein. The channel is maintained by a metallic stent. The procedure can be performed in patients who have failed sclerotherapy and is an additional option to the surgical techniques of portocaval, mesocaval, and splenorenal shunts. It takes one to three hours to perform. (JAMA 1995;273(23):1824-30) Portosystemic Shunt, Transjugular Intrahepatic,TIPS,TIPSS,Shunt, Transjugular Intrahepatic Portasystemic,Shunt, Transjugular Intrahepatic Portosystemic,Transjugular Intrahepatic Portasystemic Shunt

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