Radiological Placement of Peritoneal Ports Under Sonographic and Fluoroscopic Guidance for the Palliative Treatment of Malignant Ascites

The purpose of the study was to report and describe a minimally invasive method for palliative drainage of symptomatic malignant ascites. This would be achieved by placing a peritoneal port in the Interventional Radiology Suite. The benefit of this is it would allow patients to avoid repetitive trips to the Radiology Department for paracentesis and for paracentesis to be performed by the palliative care team at home.

Since 2002, 780 patients received either a chest or a brachial port in the Department of Radiology at Westmead Private Hospital. The procedure was modified and used for the placement of tunnelled multiple side holed Peritoneal Ports using a modified Seldinger technique in the Interventional Radiology Suite. According to the literature, there is to date no description of placement of Peritoneal Ports in the Interventional Suite.Participants first undertook an initial evaluation by ultrasound of the vasculature of the anterior abdominal wall as well as of the peritoneal cavity to find a large pocket of ascites. All following procedures were performed on an outpatient basis using only buffered Xylocaine 2% without conscious sedation. This was a novel method as the procedure did not require surgical intervention in theatre.Researchers found that patients with symptomatic ascites were able to be drained at home. These participants all achieved significant improvement in symptoms attributable to the ascites. Researchers believe that based on these findings, the complication rate will be much lower than with tunnelled peritoneal catheters placed for palliative drainage of malignant ascites.Researchers concluded that percutaneous placement of Peritoneal Ports in the Interventional Radiology Suite appears to be a viable and safe technique in patients who have symptomatic ascites that require frequent therapeutic paracentesis for relief of their symptoms.