Wall suction-assisted image-guided therapeutic paracentesis: a safe and less expensive alternative to evacuated bottles

• Published in: Abdominal imaging 2016-07, Vol.41 (7), p.1333-1337
• Main Authors: Kelil, Tatiana, Shyn, Paul B., Wu, Loraine E., Levesque, Vincent M., Kacher, Daniel, Khorasani, Ramin, Silverman, Stuart G.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Ascites - diagnostic imaging; Ascites - etiology; Ascites - surgery; Cost Savings; Drainage; Female; Gastroenterology; Hepatology; Humans; Image-Guided Biopsy; Imaging; Male; Medicine; Medicine & Public Health; Middle Aged; Paracentesis - instrumentation; Paracentesis - methods; Postoperative Complications; Quality Improvement; Radiography, Interventional; Radiology; Retrospective Studies; Suction; Surgical Instruments - economics; Tomography, X-Ray Computed
• ISSN: 2366-004X; 2366-0058
• DOI: 10.1007/s00261-016-0634-x

Objective To assess the safety and cost savings of using wall suction and plastic canisters instead of evacuated bottles, currently in short supply, to drain, and collect large amounts of fluid during image-guided paracentesis procedures. Materials and methods In a hospital-based practice, 551 image-guided paracenteses were performed in 191 consecutive patients over a 10-month period, using wall suction to facilitate drainage. Total volume of fluid removed and complications were recorded. Complications were graded using Common Terminology Criteria for Adverse Events. The pressure generated from the wall suction at our institution was measured using a manometer and compared to that of an empty evacuated bottle. Cost savings per procedure were estimated by calculating the difference in the price of supplies used to collect the average volume of fluid removed per procedure for each method. Results The mean volume of fluid removed per procedure was 3541 mL. Four (0.72%) complications occurred in 551 procedures. One grade I complication consisted of a prolonged puncture site leak of ascites. Three Grade III complications included infection, hypotension, and atrial fibrillation. All four complications appeared unrelated to the use of wall suction and were treated successfully. Maximum pressure generated from the wall suction at our institution was less than the initial pressure generated from an empty evacuated bottle. Estimated cost savings per procedure was $33.92. Conclusion The use of wall suction and plastic canisters to drain and collect fluid during image-guided therapeutic paracenteses is a safe alternative to using evacuated glass bottles and reduces per-procedure costs.