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Optimal management of ascites
Author(s) -
Rudler Marika,
Mallet Maxime,
Sultanik Philippe,
Bouzbib Charlotte,
Thabut Dominique
Publication year - 2020
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.14361
Subject(s) - ascites , medicine , paracentesis , cirrhosis , spontaneous bacterial peritonitis , liver transplantation , complication , intensive care medicine , liver disease , albumin , gastroenterology , transplantation , surgery
Ascites is the most common complication of cirrhosis, which develops in 5%‐10% of patients per year. Its management is based on symptomatic measures including restriction of sodium intake, diuretics and paracentesis. Underlying liver disease must always be treated and may improve ascites. In some patients, ascites is not controlled by medical therapies and has a major impact on quality of life and survival. TIPS placement and liver transplantation must therefore be discussed. More recently, repeated albumin infusions and Alfapump ® have emerged as new therapies in ascites. In this review, the current data on these different options are analysed and an algorithm to help the physician make clinical decisions is suggested.