Current treatment approaches to non-cancer refractory ascites
DOI: 10.32364/2587-6821-2024-8-5-10
A.N. Severtsev, A.A. Khalbaginov, S.V. Siluyanov, A.D. Dzhabarova, Sh.B. Amiraslanov
Pirogov Russian National Research Medical University, Moscow, Russian Federation
Refractory ascites (RA), which complicates the course of cirrhosis, significantly worsens the prognosis and reduces the survival rate by up to six months. Therefore, the search for an optimal treatment approach for this condition is of great importance. RA is defined as ascites that does not respond clinically to dietary sodium restriction and high-dose diuretics or that recurs rapidly after therapeutic paracentesis. The majority of patients with RA should be considered candidates for liver transplantation, which remains the most reliable treatment for cirrhosis. However, due to the limited availability of transplantation, medical and alternative surgical treatments for RA, as well as their combinations, are being actively pursued as potential alternatives. Currently, there are several options for the treatment of RA, including medical therapy, serial high-volume paracentesis, transjugular intrahepatic portosystemic shunts and implanted drainage devices, cell-free and concentrated reinfusion therapy. Each method has its advantages and disadvantages, and the final choice of the optimal therapeutic strategy is sometimes a difficult task. This article discusses modern approaches to the treatment of RA.
Keywords: refractory ascites, cirrhosis, therapeutic paracentesis, portosystemic shunt, reinfusion therapy.
For citation: Severtsev A.N., Khalbaginov A.A., Siluyanov S.V., Dzhabarova A.D., Amiraslanov Sh.B. Current treatment approaches to non-cancer refractory ascites. Russian Medical Inquiry. 2024;8(5):307–311 (in Russ.). DOI: 10.32364/2587-6821-2024-8-5-10.
ABOUT THE AUTHORS:
Aleksey N. Severtsev — Dr. Sc. (Med.), Professor, Head of the Department of Hospital Surgery No. 1, Pirogov Russian National Research Medical University; 1, Ostrovityanov str., Moscow, 117437, Russian Federation; ORCID iD 0009-0002-3847-8387.
Arsen A. Khalbaginov — surgeon, postgraduate student of the Department of Hospital Surgery No. 1, Pirogov Russian National Research Medical University; 1, Ostrovityanov str., Moscow, 117437, Russian Federation; ORCID iD 0000-0002-8461-8187.
Sergey V. Siluyanov — C. Sc. (med.), associate professor of the Department of Hospital Surgery No. 1, Pirogov Russian National Research Medical University; 1, Ostrovityanov str., Moscow, 117437, Russian Federation; ORCID iD 0009-0001-6548-8866.
Afag D.K. Dzhabarova — assistant of the Department of Hospital Surgery No. 1, Pirogov Russian National Research Medical University; 1, Ostrovityanov str., Moscow, 117437, Russian Federation; ORCID iD 0009-0009-7137-3465.
Shikhislam B. Amiraslanov — student of the 5th course, Pirogov Russian National Research Medical University; 1, Ostrovityanov str., Moscow, 117437, Russian Federation; ORCID iD 0009-0003-0202-353X.
Contact information: Sergey V. Siluyanov, e-mail: sylserg@yandex.ru.
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interest.
Received 10.04.2024.
Revised 03.05.2024.
Accepted 28.05.2024.
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