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Ascites is the commonest complication of end\u2010stage liver disease and large volume paracentesis (LVP) the accepted management strategy where refractory to medical treatment. In malignant ascites, permanent indwelling peritoneal catheters (PIPC) are an established palliative intervention. The aims are to describe available data using permanent indwelling peritoneal catheters in refractory ascites due to end\u2010stage liver disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using systematic review methodology, databases were searched (MEDLINE, EMBASE, CINAHL [The Cumulative Index to Nursing and Allied Health Literature], Google Scholar and Cochrane Database of Systematic Reviews from inception\u2010March 2018), for studies combining ascites and palliative care. Inclusion and exclusion criteria were applied to results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Following initial and updated searches, 225 studies were identified for full text review, 18 were eligible for final analysis. The studies displayed heterogeneity in design, reported on different indwelling catheters and were overall of low quality. Only one pilot randomised controlled trial was identified, of PIPC versus LVP, recruiting one patient into each arm. Technical insertion success was 100%, with low rates of non\u2010infectious complications (&lt;12%), none life threatening. Rates of bacterial peritonitis were not unacceptably high (12.7%), considering this was an end\u2010stage liver disease population and only a minority utilising long\u2010term prophylactic antibiotics. Only one study attempted quality\u2010of\u2010life assessments; none addressed potential health economic benefits.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Despite lack of well\u2010designed studies, preliminary data suggests low significant complication rates; however safety and efficacy of permanent indwelling peritoneal catheters in end\u2010stage liver disease remains to be confirmed. Further prospective randomised controlled trials are warranted, potentially translating permanent indwelling peritoneal catheters into improved palliative care in end\u2010stage liver disease.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.14162","type":"journal-article","created":{"date-parts":[[2019,6,1]],"date-time":"2019-06-01T14:29:40Z","timestamp":1559399380000},"page":"1594-1607","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":48,"title":["Permanent indwelling peritoneal catheters for palliation of refractory ascites in end\u2010stage liver disease: A systematic review"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4324-0138","authenticated-orcid":false,"given":"Lucia","family":"Macken","sequence":"first","affiliation":[{"name":"Department of Clinical and Experimental Medicine, Brighton and Sussex Medical School Brighton UK"},{"name":"Department of Gastroenterology and Hepatology Brighton and Sussex University Hospitals NHS Trust Brighton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Hashim","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, Brighton and Sussex Medical School Brighton UK"},{"name":"Department of Gastroenterology and Hepatology Brighton and Sussex University Hospitals NHS Trust Brighton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"Mason","sequence":"additional","affiliation":[{"name":"Department of Palliative Care Brighton and Sussex University Hospitals NHS Trust Brighton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7021-8409","authenticated-orcid":false,"given":"Sumita","family":"Verma","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, Brighton and Sussex Medical School Brighton UK"},{"name":"Department of Gastroenterology and Hepatology Brighton and Sussex University Hospitals NHS Trust Brighton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,7,17]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61838-9"},{"key":"e_1_2_10_3_1","unstructured":"National end of life care intelligence network. 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