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Langenbeck's Archives of Surgery

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01-12-2015 | ORIGINAL ARTICLE

Automated low flow pump system for the treatment of refractory ascites: a single-center experience

Authors: M. N. Thomas, G. H. Sauter, A. L. Gerbes, M. Stangl, T. S. Schiergens, M. Angele, J. Werner, M. Guba

Published in: Langenbeck's Archives of Surgery | Issue 8/2015

Abstract

Introduction

Ascites is a common complication of liver cirrhosis and represents the main cause of hospitalization among patients with cirrhosis. First-line therapy for those patients is the use of diuretics and dietary sodium restriction. However, 10 % of patients per year become therapy refractory to diuretic treatment with the need of repeated high-volume paracentesis or transjugular intrahepatic portosystemic shunt (TIPS). For these patients, an automated pump system (Alfapump/Sequana Medical) was developed. Here, we describe our single-center experience of ten consecutively implanted pump systems.

Patients and methods

Between 08/13 and 11/14, ten Alfapump systems were implanted in patients with refractory ascites all suffering from liver cirrhosis. Those patients were treated as a bridge to transplant (4/10) or as an end-stage therapy (6/10). Median follow-up was 165 days (23–379 days).

Results

Postimplant, the need of paracentesis could be markedly reduced to a mean of 0.45 (0–4/month) per month. In eight patients, paracentesis was not needed after implantation of the pump system. The median daily output volume was 1000 ml/day (450–2000 ml/day). Prerenal insufficiency was a recurrent complication in the postoperative period.

Discussion

The Alfapump system is a useful system in the treatment of patients suffering from therapy refractory ascites. However, due to the high level of comorbidities, careful patient selection and postoperative monitoring are required.

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Title: Automated low flow pump system for the treatment of refractory ascites: a single-center experience
Authors: M. N. Thomas
G. H. Sauter
A. L. Gerbes
M. Stangl
T. S. Schiergens
M. Angele
J. Werner
M. Guba
Publication date: 01-12-2015
Publisher: Springer Berlin Heidelberg
Published in: Langenbeck's Archives of Surgery / Issue 8/2015
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-015-1356-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Automated low flow pump system for the treatment of refractory ascites: a single-center experience

Abstract

Introduction

Patients and methods

Results

Discussion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Patients and methods

Results

Discussion

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