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Cited by 680Liver Disease and TransplantationHeart Failure Treatment and ManagementLiver Disease Diagnosis and Treatment

The DOI matches its Crossref record; 430 of the 430 references it cites were found in a registry or an index.

Guidelines on the management of ascites in cirrhosis

Open access
Aithal, Guruprasad P, Palaniyappan, Naaventhan, China, Louise, Härmälä, Suvi, Macken, Lucia, Ryan, Jennifer M, Wilkes, Emilie A, Moore, Kevin, Leithead, Joanna A, Hayes, Peter C, O"Brien, Alastair J, Verma, Sumita·2021·Gut
DOI 10.1136/gutjnl-2020-321790PMC PMC7788190
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Abstract

The British Society of Gastroenterology in collaboration with British Association for the Study of the Liver has prepared this document. The aim of this guideline is to review and summarise the evidence that guides clinical diagnosis and management of ascites in patients with cirrhosis. Substantial advances have been made in this area since the publication of the last guideline in 2007. These guidelines are based on a comprehensive literature search and comprise systematic reviews in the key areas, including the diagnostic tests, diuretic use, therapeutic paracentesis, use of albumin, transjugular intrahepatic portosystemic stent shunt, spontaneous bacterial peritonitis and beta-blockers in patients with ascites. Where recent systematic reviews and meta-analysis are available, these have been updated with additional studies. In addition, the results of prospective and retrospective studies, evidence obtained from expert committee reports and, in some instances, reports from case series have been included. Where possible, judgement has been made on the quality of information used to generate the guidelines and the specific recommendations have been made according to the ‘Grading of Recommendations Assessment, Development and Evaluation (GRADE)’ system. These guidelines are intended to inform practising clinicians, and it is expected that these guidelines will be revised in 3 years’ time.

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Crossref · 10.1136/gutjnl-2020-321790

Cites

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Statistics

Figures

Figure 1 The pathogenesis of ascites in cirrhosis.
Figure 1 The pathogenesis of ascites in cirrhosis.CC BY-NC · PubMed Central
Figure 2 The ascitic fluid samples required from diagnostic paracentesis. *These investigations should be considered based on pretest probability of specific diagnosis. BNP, brain natriuretic peptide.
Figure 2 The ascitic fluid samples required from diagnostic paracentesis. *These investigations should be considered based on pretest probability of specific diagnosis. BNP, brain natriuretic peptide.CC BY-NC · PubMed Central
Figure 3 Approach to the use of diuretics in the management of ascites in patients with cirrhosis.
Figure 3 Approach to the use of diuretics in the management of ascites in patients with cirrhosis.CC BY-NC · PubMed Central
Figure 4 Anatomical landmarks for the safe performance of paracentesis [A] and performance of ascites drainage in patients with large ascites [B].
Figure 4 Anatomical landmarks for the safe performance of paracentesis [A] and performance of ascites drainage in patients with large ascites [B].CC BY-NC · PubMed Central

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Citations

Cites

Research works printed but not linked: 2

  1. Rowley, 2018, Ultrasound imaging guidance and large volume paracentesis: an analysis of safety, cost-effectiveness, and utility in restricting unnecessary transfusion, Hepatology, 68, 568a
  2. Pérez, 1995, Paracentesis Masiva Con Reposician de dextran 70 vs Albumina en Pacientes cirrhotics Con ascites a tension, Rev Gastro Max, 60, 22

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Metadata

Authors
Aithal, G. P., Palaniyappan, N., China, L., Härmälä, S., Macken, L., Ryan, J. M., Wilkes, E. A., Moore, K., Leithead, J. A., Hayes, P. C., O"Brien, A. J., & Verma, S.
Affiliations
  • Nottingham University Hospitals NHS Trust (GB)
  • University College London (GB)
  • Brighton and Sussex Medical School (GB)
  • Royal Free London NHS Foundation Trust (GB)
  • Cambridge University Hospitals NHS Foundation Trust (GB)
  • Edinburgh Royal Infirmary (GB)
Corresponding author
Aithal, Guruprasad P
ORCID
Venue
Gut
Publisher
BMJ
Published
2020-10-16
Volume
70
Issue
1
Pages
9-29
ISSN
  • 0017-5749 (ISSN-L)
  • 1468-3288
DOI
10.1136/gutjnl-2020-321790
PMC
PMC7788190
OpenAlex
W2144187699
Cited by
680
References
430
Citations by year
2026: 47 · 2025: 93 · 2024: 78 · 2023: 82 · 2022: 78 · 2021: 39 · 2020: 25
FWCI
32.92
Type
journal article
Language
en
Open access
Licence
Locations
  • Gut (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Repository@Nottingham (University of Nottingham) (publishedVersion, cc-by-nc)
  • Repository@Nottingham (University of Nottingham) (submittedVersion, cc-by-nc)
  • Sussex Research Online (University of Sussex) (submittedVersion, cc-by-nc)
  • UCL Discovery (University College London) (submittedVersion)
  • Figshare (submittedVersion, cc-by-nc)
  • Apollo (University of Cambridge) (submittedVersion, cc-by-nc)
  • Apollo
Funders
  • Nottingham University Hospitals NHS Trust
  • National Institute for Health and Care Research (PB-PG-0214-33068, CL-2017-12-002)
  • Academy of Medical Sciences (SGL024\1044)
  • University of Nottingham
Topics
  • Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
  • Health Sciences › Medicine › Hepatology › Liver Disease Diagnosis and Treatment
Keywords
ascites, liver cirrhosis, diuretics, therapeutic paracentesis, albumin, transjugular intrahepatic portosystemic shunt, spontaneous bacterial peritonitis, beta-blockers, portal hypertension
MeSH terms
Ascites, Humans, Liver Cirrhosis

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