Background Large volume ascites has a significant impact on a patient’s quality of life. Previously, the only alternative to repeated paracentesis for refractory ascites has been the insertion of a permanent tunnelled drain placed by a radiologist. These are associated with limitation in the volume of ascites that can be drained in the community. The Perkustay offers a less invasive alternative to tunnelled drains and are able to be inserted and managed wholly within the community setting.

Aim To assess the feasibility of the hospice offering Perkustay drains to patients to avoid further hospital admissions for the management of their ascites and to document the cost benefits and improvement in morbidity and quality of life for patients.

Method A feasibility study was undertaken. All patients who were referred to the hospice for paracentesis were assessed for their suitability for insertion of Perkustay. Inclusion criteria included history of previous drainage, speed the ascites had reaccumulated and patient suitability for an indwelling drain. Outcome data was recorded from use of patient questionnaires detailing their experience and the benefit they reported in symptoms. For comparison, data was also collected about their previous experience of drainage.

Results Over six months, eight patients were referred. Three patients continued to have a Perkustay. Significant benefits were reported by all patients who underwent insertion, captured on post intervention feedback questionnaires. These included improvements in pain, breathlessness, nausea, appetite, mobility as well as psychosocial benefits. Each participant’s circumstances were unique, varying from one participant who had the drain in for 5 weeks, to another in the last days of life for whom the Perkustay meant ascites could be drained more gradually.

Conclusion This initial feasibility study has highlighted the potential for use of Perkustay drains for rapidly reaccumulating ascites. The potential cost savings and reported improvement in quality of life are significant.