Pigtail Catheter: a Less Invasive Option for Pleural Drainage of Recurrent Hepatic Hydrothorax

NCT ID: NCT02119169

Last Updated: 2017-12-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-03-31

Study Completion Date

2022-12-31

Brief Summary

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The effectiveness of pigtail catheter as a less invasive option for pleural drainage in patients with resistant hepatic hydrothorax.

Detailed Description

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Hepatic hydrothorax (HH) is defined as a transudative pleural effusion in patients with liver cirrhosis in the absence of cardiopulmonary disease. The estimated prevalence among patients with liver cirrhosis is approximately 5-6% (Baikati et al., 2014).

HH is an infrequent but a well-known complication of portal hypertension. Trans-diaphragmatic passage of ascitic fluid from peritoneal to the pleural cavity through numerous diaphragmatic defects has been shown to be the predominant mechanism in the formation of HH (Kumar\&Kumar, 2014).

Patients with hepatic hydrothoraces often have few options (Goto et al., 2011). Diuretic-resistant HH could be managed with liver transplantation, transjugular intrahepatic portosystemic shunt (TIPS) or indwelling pleural catheters. However, tube thoracotomy and pleurodesis failed in most patients (Singh et al., 2013).

Case reports and small case series have reported a high rate of complications associated with chest tube placement for hepatic hydrothorax. The most common reported complications were acute kidney injury, pneumothorax, and empyema. Death has been recorded in some cases. Chest tube insertion for hepatic hydrothorax carries significant morbidity and mortality, with questionable benefit (Orman\&Lok, 2009).

Pigtail catheter insertion is an effective and safe method of draining pleural fluid. Its use is safe and recommended for all cases of pleural effusion requiring chest drain except for empyema and other loculated effusions that yielded low success rate (Bediwy and Amer, 2012).

Conditions

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Pleural Effusion

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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pigtail catheter

Pigtail catheter for pleural drainage of recurrent hepatic hydrothorax

Group Type EXPERIMENTAL

Pigtail catheter

Intervention Type DEVICE

pigtail catheter for pleural drainage

Interventions

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Pigtail catheter

pigtail catheter for pleural drainage

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Patients with cirrhotic liver and recurrent pleural effusion.
* Pleural fluid should be transudate according to Light's criteria:

* Pleural fluid-to-serum protein ratio less than 0.5
* Pleural fluid lactic dehydrogenase (LDH) less than 200 IU
* Pleural fluid-to-serum LDH ratio and pleural fluid-to-high normal serum LDH ratio less than 0.6

Exclusion Criteria

* Diagnosis of hepatocellular carcinoma or other neoplasm able to shorten life expectancy.
* Congestive heart failure.
* Recent (i.e. within the previous 2 weeks) episode of digestive hemorrhage.
* Exudative pleural effusion.
* Ascitic fluid or pleural fluid infection
* Platelet count below 50,000
* Prothrombin activity below 50%
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Tanta University

OTHER

Sponsor Role collaborator

Sherief Abd-Elsalam

OTHER

Sponsor Role lead

Responsible Party

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Sherief Abd-Elsalam

doctor

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Mohamed A. Sharaf-Eldin, professor

Role: PRINCIPAL_INVESTIGATOR

TUH

Adel S Bediwy, Professor

Role: STUDY_DIRECTOR

TUH

Sherief M Abd-Elsalam, Doctor

Role: STUDY_CHAIR

TUH

Abdelrahman a kobtan, doctor

Role: STUDY_CHAIR

TUH

Locations

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Tanta university hospital

Tanta, , Egypt

Site Status RECRUITING

Countries

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Egypt

Central Contacts

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Sherief M Abd-Elsalam, doctor

Role: CONTACT

Phone: 00201000040794

Email: [email protected]

Facility Contacts

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Abd-Elsalam

Role: primary

References

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Sharaf-Eldin M, Bediwy AS, Kobtan A, Abd-Elsalam S, El-Kalla F, Mansour L, Elkhalawany W, Elhendawy M, Soliman S. Pigtail Catheter: A Less Invasive Option for Pleural Drainage in Egyptian Patients with Recurrent Hepatic Hydrothorax. Gastroenterol Res Pract. 2016;2016:4013052. doi: 10.1155/2016/4013052. Epub 2016 Jun 2.

Reference Type DERIVED
PMID: 27340399 (View on PubMed)

Other Identifiers

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Tanta university hospital

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

Mohamed Sharaf-Eldin

Identifier Type: -

Identifier Source: org_study_id