Day case paracentesis

The paracentesis clinic is a day case clinic provided by the Hepatology team at Bristol Royal Infirmary. It is usually run by Victoria Iji, the Hepatology Physician Associate. The aim of the clinic is to help manage symptomatic ascites and to try and alleviate some of those associated symptoms, such as abdominal discomfort, shortness of breath, poor appetite and help reduce or control the accumulation of fluid (oedema) in the legs. We consider this procedure when diuretics (water tablets) are not effective in keeping the fluid away.

It is also an opportunity to keep in touch with those patients with decompensated cirrhosis and identify any new issues/symptoms that we may be able to help with, as well as flag any patient that may need to be seen by a consultant for further assessments and interventions.

The procedure is usually performed on ward A900, the patient will attend at 8am for an assessment and if the procedure is appropriate, it will then be performed usually by Victoria, though there are many other professions involved in this service who may also perform the procedure, including doctors and specialist nurses. The patient remains on the unit for 6 hours, during this time they will have their bloods reviewed and may receive some protein via a drip to help prevent the fluid from re-accumulating to their abdomen too quickly.

Before the procedure it is important that we ensure it is safe to perform and to do this the patient will need to have a tense abdomen and we usually agree an ideal weight to reach before we drain. It is important we only perform a drain when it is safe to do so as there are many risks associated with the procedure if drained too early.

You can call the hepatology secretaries on 0117 342 7707 or email Victoria.Iji@uhbw.nhs.uk to book a drain slot or discuss whether you might be ready for a drain.