A safe and effective treatment for refractory malignant ascites: the use of pigtail catheters.

Abstract

Purpose: Recurrent malignant ascites is a common and challenging condition in cancer patients, often lacking a standardized treatment protocol. Small-scale studies in the literature have been insufficient to establish a treatment standard. The aim of our study was to investigate the effectiveness and safety of pigtail peritoneal catheter application in the treatment of malignant ascites.

Material and methods: We conducted a retrospective analysis of patients who had pigtail catheters inserted between January 2017 and December 2022. The study focused on the success rate of the procedure, catheter dwell time, complication rates, and the factors influencing these outcomes.

Results: A total of 196 patients, 102 of whom were female, with malignant ascites were included in the study. The median age was 65.5 years. The procedure had a 100% success rate, with no procedure-related deaths or major complications. The overall minor complication rate, including bleeding, minor cellulitis, leakage, and blockage, was 52%. Patients with comorbidities experienced statistically significantly more complications (p < 0.05). The median catheter dwell time was 31 days (range: 3-181 days).

Conclusions: Pigtail peritoneal catheters provide effective and safe minimally invasive fluid drainage for the treatment of malignant ascites. The most critical factors for preventing procedure-related complications and ensuring procedural success include proper indication, correct timing, procedural expertise, and the involvement of well-trained patients and caregivers.