EUS-GUIDED DRAINAGE OF REFRACTORY MALIGNANT ASCITES

Malignant refractory ascites needs multiple paracentesis. We report our results (Table 1), in draining malignant ascites into the stomach by EUS-guidance, placing 10F plastic double pigtail stents. Our aims were to avoid repeated paracentesis and possible drawbacks of metallic stents like hemodynamic, electrolyte imbalance and, preventing free-pass of cavity contents. Procedures were performed after carefully discussion of its experimental nature. In this preliminary experience, neither hemodynamic nor electrolytic impairment after the procedures were observed. Patients have a poor clinical condition with short survival after the procedures. In case 1, pneumoperitoneum was resolved after puncturing the abdominal wall with a 14G catheter. Case 3 needed the placement of a second pigtail due to relapse of ascites*. More studies are needed to draw conclusions on safety and effectiveness of EUS-guided ascites drainage.