Safety and Effectiveness of Palliative Tunneled Peritoneal Drainage Catheters in the Management of Refractory Malignant and Non-malignant Ascites

  • Jennifer A. Knight
  • Scott M. Thompson
  • Chad J. Fleming
  • Emily C. Bendel
  • Melissa J. Neisen
  • Newton B. Neidert
  • Andrew H. Stockland
  • Haraldur Bjarnason
  • David A. Woodrum
Clinical Investigation



To determine the safety and effectiveness of tunneled peritoneal catheters in the management of refractory malignant and non-malignant ascites.

Materials and Methods

An IRB-approved retrospective review was undertaken of patients who underwent ultrasound and fluoroscopy-guided tunneled peritoneal catheter placement for management of refractory malignant or non-malignant ascites between January 1, 2009, and March 14, 2014.


A total of 137 patients (76 M/61 F, mean age 62.9 years) underwent tunneled peritoneal catheter placement for refractory malignant (N = 119; 86.9%) or non-malignant (N = 18; 13.1%) ascites. Technical success was 100% with no immediate complications. Nineteen patients (13.9%) experienced a total of 11 minor and 12 major complications. Nine patients developed a catheter-associated infection. The remaining complications included leakage at the dermatotomy site (N = 8), catheter dislodgement (N = 2), obstruction (N = 2), and groin pain (N = 2). Patients who developed a catheter-associated infection had a significantly longer catheter dwell time compared to those who did not develop an infection (median, 96.5 vs. 20 days; p < 0.01). Nine patients (6.6%) were lost to follow-up. Of the remaining 128 patients, 125 died and the majority had a catheter in place (90.4%) at the time of death. There was one catheter-associated death (bacterial peritonitis; 0.8%). The median time from catheter placement to death was significantly shorter in patients with malignant versus non-malignant ascites (18.5 vs. 85 days; p < 0.0001).


Tunneled peritoneal drainage catheters are effective and relatively safe in the management of malignant and non-malignant ascites. Longer catheter dwell time may be a risk factor for catheter-associated infection, particularly in patients with a longer anticipated survival in the palliative setting.


Indwelling peritoneal catheter Abdominal ascites Drainage 



The authors report no funding related to the content of this manuscript.

Compliance with Ethical Standards

Conflict of interest

Dr. Woodrum reports personal fees from Galil Medical and personal fees from CLS Medical, outside the submitted work.

Informed Consent

For this type of study, formal consent is not required. All study subjects had a Minnesota Research Authorization allowing use of medical records for research purposes.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2018

Authors and Affiliations

  • Jennifer A. Knight
    • 1
  • Scott M. Thompson
    • 2
  • Chad J. Fleming
    • 2
  • Emily C. Bendel
    • 2
  • Melissa J. Neisen
    • 2
  • Newton B. Neidert
    • 2
  • Andrew H. Stockland
    • 2
  • Haraldur Bjarnason
    • 2
  • David A. Woodrum
    • 2
  1. 1.Mayo Clinic School of MedicineRochesterUSA
  2. 2.Department of RadiologyMayo Clinic School of MedicineRochesterUSA

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