Autogenous ascitic infusion in the management of the cirrhotic surgical patient.

Abstract

OPERATIONS UPON PATIENTS with ascites carry an operative risk greater than that of similar procedures upon patients suffering from the same basic disease but free of ascites. Removal of the ascites either preoperatively or at laparotomy results in hemodynamic changes and loss of water, electrolytes and protein which not infrequently lead to vascular collapse, hepatic decompensation, and other metabolic complications. If the fluid is not aspirated preoperatively, respiratory function may be impaired. Furthermore, uncontrolled leakage of the fluid during an abdominal operation and through the incision postoperatively enhances the possibility of infection. Interest has been renewed recently in the treatment of medically refractory, cirrhotic ascites by simultaneous abdominal paracentesis and intravenous infusion of unmodified autogenous ascitic fluid. 1-3 Metabolic studies during 13 such procedures have been reported. 4 It has proved to be a safe, simple, and efficacious adjunct to the management of this problem. It produces a prompt