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Long-term clinical outcome of large volume paracentesis with intravenous albumin in patients with spontaneous bacterial peritonitis: A randomized prospective study

Authors
 CHANG HWAN CHOI  ;  SANG HOON AHN  ;  DO YOUNG KIM  ;  SANG KIL LEE  ;  JEONG YOUP PARK  ;  CHAE YOON CHON  ;  YOUNG MYOUNG MOON  ;  KWANG-HYUB HAN 
Citation
 JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Vol.20(8) : 1215-1222, 2005 
Journal Title
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
ISSN
 0815-9319 
Issue Date
2005
MeSH
Albumins/administration & dosage ; Ascites/microbiology ; Ascites/prevention & control ; Ascites/therapy ; Bacterial Infections/microbiology ; Bacterial Infections/prevention & control ; Bacterial Infections/therapy* ; Cause of Death ; Combined Modality Therapy ; Diuretics/administration & dosage ; Female ; Humans ; Length of Stay ; Liver Cirrhosis/complications ; Male ; Middle Aged ; Paracentesis/adverse effects ; Paracentesis/methods* ; Peritonitis/microbiology ; Peritonitis/prevention & control ; Peritonitis/therapy* ; Prospective Studies ; Secondary Prevention ; Survival Analysis ; Treatment Outcome
Keywords
large volume paracentesis ; spontaneous bacterial peritonitis ; survival ; treatment outcome
Abstract
BACKGROUND AND AIM: Large volume paracentesis (LVP) with plasma volume expansion has been used for tense or refractory ascites. However, still in question is whether it is safe and effective for the treatment of spontaneous bacterial peritonitis (SBP). We addressed this issue and conducted a study to assess safety and long-term outcome of LVP in cirrhotic patients with SBP.
METHODS: Forty-two randomly assigned cirrhotic patients with SBP were classified into two groups; Group 1 included 21 patients who were treated with LVP and intravenous albumin; and Group 2 included 21 patients who were treated with diuretics and intravenous albumin.
RESULTS: The overall cumulative survival rate was poor in patients with SBP (42.5% and 22.5% at 6 and 12 months, respectively). At 7 days after treatment, the blood tests were similar between the two groups. In the ascitic fluid, the white blood cell counts decreased significantly and the protein concentrations tended to increase in both groups. In-hospital days, resolution rate of SBP, and in-hospital mortality rate were similar between the two groups. Although complication rates tended to be slightly higher in Group 1, long-term cumulative survivals were similar between Group 1 and Group 2. LVP was effective in removing abdominal discomfort in patients with tense ascites without serious complication.
CONCLUSIONS: LVP with intravenous albumin was as effective as diuretics with intravenous albumin for the treatment of SBP with similar mortality. LVP with intravenous albumin might be feasible for the treatment of tense or refractory ascites in cirrhotic patients with SBP.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/j.1440-1746.2005.03861.x/abstract
DOI
10.1111/j.1440-1746.2005.03861.x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
Park, Jeong Youp(박정엽) ORCID logo https://orcid.org/0000-0003-0110-8606
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Lee, Sang Kil(이상길) ORCID logo https://orcid.org/0000-0002-0721-0364
Chon, Chae Yoon(전재윤)
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/151122
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