Comparative Outcomes of Indwelling Peritoneal Catheters (IPCs) versus Large Volume Paracentesis (LVP) in the Management of Malignant and Non-Malignant Ascites: A Systematic Literature Review
Author(s)
Ning-Ling Huang, MS1, Monica Telinoiu, MBA, MS2, Shaneé Armstrong, BS, MBA3, Mutsuo Yamazaki, PhD4, Takeshi Tomaru, BS4, Hiroshi Kubo, MD, PhD4.
1Becton, Dickinson and Company, Singapore, Singapore, 2Becton, Dickinson and Company, Franklin Lakes, NJ, USA, 3Becton, Dickinson and Company, Tempe, AZ, USA, 4Nippon Becton Dickinson Company, Tokyo, Japan.
1Becton, Dickinson and Company, Singapore, Singapore, 2Becton, Dickinson and Company, Franklin Lakes, NJ, USA, 3Becton, Dickinson and Company, Tempe, AZ, USA, 4Nippon Becton Dickinson Company, Tokyo, Japan.
OBJECTIVES: Although large volume paracentesis (LVP) is frequently used for malignant (MA) and non-malignant ascites (NMA), indwelling peritoneal catheters (IPCs) are increasingly recognized as a valuable alternative for patients requiring frequent fluid removal. To evaluate the potential advantages of IPCs over LVP, a systematic literature review (SLR) was conducted, focusing on improved clinical outcomes and healthcare resource utilization.
METHODS: Studies were searched in PubMed and grey literature from 1997 to 2025. A total of 253 references were retrieved, and 55 studies were included. Thirteen studies assessed IPCs vs. LVP for MA and NMA, in different settings.
RESULTS: IPCs were well-tolerated, provided improvements in quality of life (QoL), symptom relief and convenience. On a 10-point scale, nurses rated QoL improvement at an average of 9.0, symptom improvement at 9.3, and convenience at 9.6. Patients rated these aspects with QoL improvement at 9.5, symptom improvement at 9.6, and convenience at 9.7. Device-associated infection rates varied depending on the setting and patient condition. When compared to IPCs, LVP generally had a lower infection rate per procedure (0.8%) but still presented notable risks of bacterial peritonitis (8%) and cellulitis/leakage (11%). In comparison, IPCs had a higher infection rate per patient (2.5%) and substantial risks of bacterial peritonitis (33%), cellulitis/leakage (41%), and significant risk of removal due to complications like leaking and chemical cellulitis (21.4%). IPCs were found to be more cost-effective, had fewer hospitalizations (10 vs. 30 monthly), and lower costs ($4151 vs. $8401) compared to LVP, with comparable health benefits (0.08060 vs. 0.08057 QALY).
CONCLUSIONS: The findings suggests that IPCs may offer QoL and economic advantages over LVP for managing MA and NMA. Therefore, IPCs could transform the care pathway by improving quality of life for these patients while reducing hospitalizations and the associated cost burden through broader adoption.
METHODS: Studies were searched in PubMed and grey literature from 1997 to 2025. A total of 253 references were retrieved, and 55 studies were included. Thirteen studies assessed IPCs vs. LVP for MA and NMA, in different settings.
RESULTS: IPCs were well-tolerated, provided improvements in quality of life (QoL), symptom relief and convenience. On a 10-point scale, nurses rated QoL improvement at an average of 9.0, symptom improvement at 9.3, and convenience at 9.6. Patients rated these aspects with QoL improvement at 9.5, symptom improvement at 9.6, and convenience at 9.7. Device-associated infection rates varied depending on the setting and patient condition. When compared to IPCs, LVP generally had a lower infection rate per procedure (0.8%) but still presented notable risks of bacterial peritonitis (8%) and cellulitis/leakage (11%). In comparison, IPCs had a higher infection rate per patient (2.5%) and substantial risks of bacterial peritonitis (33%), cellulitis/leakage (41%), and significant risk of removal due to complications like leaking and chemical cellulitis (21.4%). IPCs were found to be more cost-effective, had fewer hospitalizations (10 vs. 30 monthly), and lower costs ($4151 vs. $8401) compared to LVP, with comparable health benefits (0.08060 vs. 0.08057 QALY).
CONCLUSIONS: The findings suggests that IPCs may offer QoL and economic advantages over LVP for managing MA and NMA. Therefore, IPCs could transform the care pathway by improving quality of life for these patients while reducing hospitalizations and the associated cost burden through broader adoption.
Conference/Value in Health Info
2025-09, ISPOR Real-World Evidence Summit 2025, Tokyo, Japan
Value in Health Regional, Volume 49S (September 2025)
Code
RWD204
Topic Subcategory
Distributed Data & Research Networks
Disease
SDC: Oncology