Recent developments in the management of ascites in cirrhosis

Author:

Lan Tian12,Chen Ming12,Tang Chengwei12,Deltenre Pierre345ORCID

Affiliation:

1. Lab of Gastroenterology and Hepatology State Key Laboratory of Biotherapy West China Hospital Sichuan University Chengdu China

2. Department of Gastroenterology West China Hospital Sichuan University Chengdu China

3. Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology CUB Hôpital Erasme Université Libre de Bruxelles Brussels Belgium

4. Department of Gastroenterology and Hepatology CHU UCL Namur Université Catholique de Louvain Yvoir Belgium

5. Department of Gastroenterology and Hepatology Clinique St Luc Bouge Belgium

Abstract

AbstractIn recent years, advances have been made for treating ascites in patients with cirrhosis. Recent studies have indicated that several treatments that have been used for a long time in the management of portal hypertension may have beneficial effects that were not previously identified. Long‐term albumin infusion may improve survival in patients with cirrhosis and ascites while beta‐blockers may reduce ascites occurrence. Transjugular intrahepatic porto‐systemic shunt (TIPS) placement may also improve survival in selected patients in addition to the control with ascites. Low‐flow ascites pump insertion can be another option for some patients with intractable ascites. In this review, we summarize the latest data related to the management of ascites occurring in cirrhosis. There are still unanswered questions, such as the optimal use of albumin as a long‐term therapy, the place of beta‐blockers, and the best timing for TIPS placement to improve the natural history of ascites, as well as the optimal stent diameter to reduce the risk of shunt‐related side‐effects. These issued should be addressed in future studies.

Publisher

Wiley

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