Managing ascites in patients with hepatocellular carcinoma: experiences from a quaternary liver centre

Abstract

Hepatocellular carcinoma is a primary liver cancer that usually develops in the background of liver cirrhosis. Liver damage and cirrhosis are often undiagnosed until patients present with symptoms of decompensation. For many patients, the development of ascites can be the first sign of their liver disease. Once patients develop ascites the symptom burden is often debilitating, affecting every aspect of their life. There are many treatment options to manage ascites, avoid emergency admissions for patients and improve quality of life. This article outlines a nurse-led ascites management pathway that is patient-focused, adopting a multidisciplinary team approach with advanced care planning, in a specialist hepatology unit.