Large-Volume Paracentesis: A Fast, Convenient, and Safe Technique

Background: Ascites is a common complication of liver cirrhosis, malignancy, cardiac failure, pancreatitis, and tuberculosis, with cirrhosis of the liver being the most common cause. Onset of ascites in cirrhosis of the liver is associated with worsened quality of life, increased risk of spontaneous bacterial peritonitis, and renal failure. Management of ascites caused by cirrhosis requires sodium restriction in diet, sodium excretion with diuretics and, in refractory cases, large volume paracentesis. Technique: We describe a simple adjustment to the standard paracentesis technique that does not require additional equipment or manpower. Conclusion: Removing over 5 L of ascitic fluid can become a time-consuming and labor-intensive process. We describe a setup that makes this commonly performed procedure fast, convenient, and safe.