Download PDF
Z Gastroenterol 2011; 49(6): 749-779
DOI: 10.1055/s-0031-1273405
Leitlinie

© Georg Thieme Verlag KG Stuttgart · New York

S3-Leitlinie „Aszites, spontan bakterielle Peritonitis, hepatorenales Syndrom”

German S 3-Guideline ”Ascites, spontaneous bacterial peritonitis, hepatorenal syndrome”A. L. Gerbes1 , V. Gülberg2 , T. Sauerbruch3 , R. Wiest4 , B. Appenrodt3 , M. J. Bahr5 , M. M. Dollinger6 , M. Rössle7 , M. Schepke8
  • 1Med. Klinik und Poliklinik 2, Leber Centrum München, Klinikum der LMU München
  • 2Medizinische Klinik Innenstadt mit Schwerpunkt Gastroenterologie, Klinikum der Universität München
  • 3Medizinische Klinik und Poliklinik I, Universitätsklinikum Bonn
  • 4Innere Medizin I, Universitätsklinikum Regensburg
  • 5Medizinische Klinik I, Sana Kliniken, Lübeck
  • 6Universitätsklinik und Poliklinik für Innere Medizin I, Universitätsklinikum Halle
  • 7Facharzt für innere Medizin, Gastroenterologie/Endokrinologie, Freiburg
  • 8Medizinische Klinik für Gastroenterologie u. Hepatologie, Helios-Klinikum Siegburg
Further Information

Publication History

Publication Date:
01 June 2011 (online)

Also available at
   Permissions and Reprints

I. Diagnostik des Aszites I.1. Einleitung: Ursachen des Aszites I.2. Wann soll eine diagnostische Aszitespunktion durchgeführt werden? I.3. Technik, Komplikationen und Kontraindikationen der Aszitespunktion I.3.1 Sollen Gerinnungsfaktoren vor einer Aszitespunktion substituiert werden? I.3.2 Welche Kontraindikationen zur Aszitespunktion bestehen? I.4. Diagnostik bei Aszitespunktion I.4.1 Welche Untersuchungen sind obligater Bestandteil der initialen Aszitespunktion? I.4.2 Welche Untersuchungen sind optionaler Bestandteil einer Aszitespunktion? I.4.3 Welche zytologischen Untersuchungen sollen durchgeführt werden? I.5. Spezifische Diagnostik bei Patienten mit Aszites bedingt durch ein Budd-Chiari-Syndrom (BCS) oder sinusoidales Obstruktionssyndrom I.6. Welche Parameter weisen auf eine sekundäre bakterielle Peritonitis hin? II. Therapie des Aszites II.1. Wann bedarf ein Patient mit Aszites einer Therapie? II.2. Was ist die Rolle der nicht medikamentösen Basistherapie? II.3. Wie wird die medikamentöse Therapie des Aszites durchgeführt? II.4. Wie wird der therapierefraktäre und rezidivierende Aszites behandelt? III. Spontan bakterielle Peritonitis III.1. Einleitung: Definition, Inzidenz und Prognose einer spontanbakteriellen Peritonitis (SBP) bzw. eines Bakteraszites III.2. Wann und wie sollte eine Primärprophylaxe einer SBP durchgeführt werden? III.3. Wie sollte eine SBP behandelt werden? III.4. Wie sollte die Sekundärprophylaxe und Nachsorge einer SBP aussehen ? IV. Hepatorenales Syndrom IV.1. Einleitung: Definition IV.2. Welchen Stellenwert hat die Albumingabe in der Therapie des HRS? IV.3. Welchen Stellenwert haben Vasokonstriktoren in der Therapie des HRS? IV.4. Gibt es einen Stellenwert des transjugulären intrahepatischen portosystemischen Shunts (TIPS) bei HRS? IV.5. Wann ist ein Nierenersatzverfahren beim HRS indiziert und welchen Stellenwert haben Leberersatzverfahren? IV.6. Wie beeinflusst das HRS die Indikation zur und den Verlauf nach Lebertransplantation? V. Hepatischer Hydrothorax V.1. Einleitung: Definition V.2. Welche Untersuchungen sind zur Abklärung eines hepatischen Hydrothoraxes notwendig? V.3. Wie sollten Patienten mit hepatischem Hydrothorax therapiert werden? V.4. Wie sollten Patienten mit rezidivierendem hepatischem Hydrothorax therapiert werden? V.5. Spontan bakterielles Empyem (SBEM) V.5.1 Wie wird ein spontan bakterielles Empyem (SBEM) diagnostiziert und therapiert? Abkürzungsverzeichnis Literatur

Die vorliegende Leitlinie wurde erstellt durch die Deutsche Gesellschaft für Verdauungs- und Stoffwechselkrankheiten (Leitung: Prof. Dr. med. A. L. Gerbes, Medizinische Klinik und Poliklinik II, Klinikum der Universität München Großhadern; Prof. Dr. T. Sauerbruch, Medizinische Klinik und Poliklinik I, Universitätsklinikum Bonn) in Zusammenarbeit mit folgenden Fachgesellschaften/Organisationen:

Deutsche Gesellschaft für Allgemein- und Viszeralchirurgie (DGAV) Deutsche Gesellschaft für Ernährungsmedizin (DGEM) Deutsche Gesellschaft für Infektiologie (DGI) Deutsche Gesellschaft für Nephrologie (DGfN) Deutsche Gesellschaft für Pathologie (DGP) Deutsche Röntgengesellschaft (DRG) Lebertransplantierte Deutschland e. V.

Literatur

  • 1 Runyon B A. Management of adult patients with ascites due to cirrhosis.  Hepatology. 2004;  39 841-856
    Google Scholar
  • 2 Arroyo V, Fernandez-Esparrach G, Gines P. Diagnostic approach to the cirrhotic patient with ascites.  J Hepatol. 1996;  25 (Suppl 1) 35-40
    Google Scholar
  • 3 Cardenas A, Chopra S. Chylous ascites.  Am J Gastroenterol. 2002;  97 1896-1900
    Google Scholar
  • 4 Almakdisi T, Massoud S, Makdisi G. Lymphomas and chylous ascites: review of the literature.  Oncologist. 2005;  10 632-635
    Google Scholar
  • 5 Runyon B A. Early events in spontaneous bacterial peritonitis.  Gut. 2004;  53 782-784
    Google Scholar
  • 6 Castellote J. Spontaneous bacterial peritonitis and reagent strips.  Hepatology. 2007;  46 1667-1668 ; author reply 1669 – 1670
    Google Scholar
  • 7 Jeffries M A, Stern M A, Gunaratnam N T et al. Unsuspected infection is infrequent in asymptomatic outpatients with refractory ascites undergoing therapeutic paracentesis.  Am J Gastroenterol. 1999;  94 2972-2976
    Google Scholar
  • 8 Evans L T, Kim W R, Poterucha J J et al. Spontaneous bacterial peritonitis in asymptomatic outpatients with cirrhotic ascites.  Hepatology. 2003;  37 897-901
    Google Scholar
  • 9 Romney R, Mathurin P, Ganne-Carrie N et al. Usefulness of routine analysis of ascitic fluid at the time of therapeutic paracentesis in asymptomatic outpatients. Results of a multicenter prospective study.  Gastroenterol Clin Biol. 2005;  29 275-279
    Google Scholar
  • 10 Robert Koch-Institut . Anforderungen der Hygiene bei Operationen und anderen invasiven Eingriffen – Mitteilung der Kommission für Krankenhaushygiene und Infektionsprävention am Robert Koch-Institut.  Bundesgesundheitsblatt. 2000;  43 644-648
    Google Scholar
  • 11 Schlottmann K, Gelbmann C, Grune S et al. A new paracentesis needle for ascites and pleural effusion compared with the venous indwelling catheter. A prospective, randomized study.  Med Klin. 2001;  96 321-324
    Google Scholar
  • 12 Gines P, Arroyo V, Rodes J. Treatment of ascites and renal failure in cirrhosis.  Baillieres Clin Gastroenterol. 1989;  3 165-186
    Google Scholar
  • 13 Shaheen N J, Grimm I S. Comparison of the Caldwell needle/cannula with Angiocath needle in large volume paracentesis.  Am J Gastroenterol. 1996;  91 1731-1733
    Google Scholar
  • 14 Boccia S, Rollo V, Accorsi L et al. Paracentesis: a new needle for an old technique.  Endoscopy. 1991;  23 83-84
    Google Scholar
  • 15 Nazeer S R, Dewbre H, Miller A H. Ultrasound-assisted paracentesis performed by emergency physicians vs. the traditional technique: a prospective, randomized study.  Am J Emerg Med. 2005;  23 363-367
    Google Scholar
  • 16 Sakai H, Sheer T A, Mendler M H et al. Choosing the location for non-image guided abdominal paracentesis.  Liver Int. 2005;  25 984-986
    Google Scholar
  • 17 Cattau Jr E L, Benjamin S B, Knuff T E et al. The accuracy of the physical examination in the diagnosis of suspected ascites.  JAMA. 1982;  247 1164-1166
    Google Scholar
  • 18 Irshad A, Ackerman S J, Anis M et al. Can the smallest depth of ascitic fluid on sonograms predict the amount of drainable fluid?.  J Clin Ultrasound. 2009;  37 440-444
    Google Scholar
  • 19 De Gottardi A, Thevenot T, Spahr L et al. Risk of complications after abdominal paracentesis in cirrhotic patients: a prospective study.  Clin Gastroenterol Hepatol. 2009;  7 906-909
    Google Scholar
  • 20 Martinet O, Reis E D, Mosimann F. Delayed hemoperitoneum following large-volume paracentesis in a patient with cirrhosis and ascites.  Dig Dis Sci. 2000;  45 357-358
    Google Scholar
  • 21 Arnold C, Haag K, Blum H E et al. Acute hemoperitoneum after large-volume paracentesis.  Gastroenterology. 1997;  113 978-982
    Google Scholar
  • 22 Grabau C M, Crago S F, Hoff L K et al. Performance standards for therapeutic abdominal paracentesis.  Hepatology. 2004;  40 484-488
    Google Scholar
  • 23 Pache I, Bilodeau M. Severe haemorrhage following abdominal paracentesis for ascites in patients with liver disease.  Aliment Pharmacol Ther. 2005;  21 525-529
    Google Scholar
  • 24 Lin C H, Shih F Y, Ma M H et al. Should bleeding tendency deter abdominal paracentesis?.  Dig Liver Dis. 2005;  37 946-951
    Google Scholar
  • 25 Mallory A, Schaefer J W. Complications of diagnostic paracentesis in patients with liver disease.  JAMA. 1978;  239 628-630
    Google Scholar
  • 26 Webster S T, Brown K L, Lucey M R et al. Hemorrhagic complications of large volume abdominal paracentesis.  Am J Gastroenterol. 1996;  91 366-368
    Google Scholar
  • 27 Minocha A. A fatal case of paracentesis.  Am J Gastroenterol. 1999;  94 856
    Google Scholar
  • 28 McVay P A, Toy P T. Lack of increased bleeding after paracentesis and thoracentesis in patients with mild coagulation abnormalities.  Transfusion. 1991;  31 164-171
    Google Scholar
  • 29 Runyon B A. Paracentesis of ascitic fluid. A safe procedure.  Arch Intern Med. 1986;  146 2259-2261
    Google Scholar
  • 30 Mannucci P M. Abnormal hemostasis tests and bleeding in chronic liver disease: are they related? No.  J Thromb Haemost. 2006;  4 721-723
    Google Scholar
  • 31 Angeloni S, Nicolini G, Merli M et al. Validation of automated blood cell counter for the determination of polymorphonuclear cell count in the ascitic fluid of cirrhotic patients with or without spontaneous bacterial peritonitis.  Am J Gastroenterol. 2003;  98 1844-1848
    Google Scholar
  • 32 Rimola A, Garcia-Tsao G, Navasa M et al. Diagnosis, treatment and prophylaxis of spontaneous bacterial peritonitis: a consensus document. International Ascites Club.  J Hepatol. 2000;  32 142-153
    Google Scholar
  • 33 Albillos A, Cuervas-Mons V, Millan I et al. Ascitic fluid polymorphonuclear cell count and serum to ascites albumin gradient in the diagnosis of bacterial peritonitis.  Gastroenterology. 1990;  98 134-140
    Google Scholar
  • 34 Jones S R. The absolute granulocyte count in ascites fluid. An aid to the diagnosis of spontaneous bacterial peritonitis.  West J Med. 1977;  126 344-346
    Google Scholar
  • 35 Runyon B A. Low-protein-concentration ascitic fluid is predisposed to spontaneous bacterial peritonitis.  Gastroenterology. 1986;  91 1343-1346
    Google Scholar
  • 36 Llach J, Rimola A, Navasa M et al. Incidence and predictive factors of first episode of spontaneous bacterial peritonitis in cirrhosis with ascites: relevance of ascitic fluid protein concentration.  Hepatology. 1992;  16 724-727
    Google Scholar
  • 37 Guarner C, Sola R, Soriano G et al. Risk of a first community-acquired spontaneous bacterial peritonitis in cirrhotics with low ascitic fluid protein levels.  Gastroenterology. 1999;  117 414-419
    Google Scholar
  • 38 Canete N, Erice E, Bargallo A et al. Natural history of spontaneous bacterial peritonitis: A longitudinal study in 263 cirrhotic patients after the first ascites decompensation.  J Hepatol. 2007;  46 S90-S91
    Google Scholar
  • 39 Pare P, Talbot J, Hoefs J C. Serum-ascites albumin concentration gradient: a physiologic approach to the differential diagnosis of ascites.  Gastroenterology. 1983;  85 240-244
    Google Scholar
  • 40 Runyon B A, Montano A A, Akriviadis E A et al. The serum-ascites albumin gradient is superior to the exudate-transudate concept in the differential diagnosis of ascites.  Ann Intern Med. 1992;  117 215-220
    Google Scholar
  • 41 Dittrich S, Yordi L M, Mattos A A. The value of serum-ascites albumin gradient for the determination of portal hypertension in the diagnosis of ascites.  Hepatogastroenterology. 2001;  48 166-168
    Google Scholar
  • 42 Runyon B A, Canawati H N, Akriviadis E A. Optimization of ascitic fluid culture technique.  Gastroenterology. 1988;  95 1351-1355
    Google Scholar
  • 43 Castellote de J, Xiol X, Verdaguer R et al. Comparison of two ascitic fluid culture methods in cirrhotic patients with spontaneous bacterial peritonitis.  Am J Gastroenterol. 1990;  85 1605-1608
    Google Scholar
  • 44 Bobadilla M, Sifuentes J, Garcia-Tsao G. Improved method for bacteriological diagnosis of spontaneous bacterial peritonitis.  J Clin Microbiol. 1989;  27 2145-2147
    Google Scholar
  • 45 Caly W R, Strauss E. A prospective study of bacterial infections in patients with cirrhosis.  J Hepatol. 1993;  18 353-358
    Google Scholar
  • 46 Kuiper J J, Buuren H R, Man de R A. Limited role for routine ascites culture as a diagnostic tool for spontaneous bacterial peritonitis in the era of prophylactic antibiotics.  J Hepatol. 2007;  46 S96
    Google Scholar
  • 47 Butani R C, Shaffer R T, Szyjkowski R D et al. Rapid diagnosis of infected ascitic fluid using leukocyte esterase dipstick testing.  Am J Gastroenterol. 2004;  99 532-537
    Google Scholar
  • 48 Castellote van J, Lopez C, Gornals J et al. Rapid diagnosis of spontaneous bacterial peritonitis by use of reagent strips.  Hepatology. 2003;  37 893-896
    Google Scholar
  • 49 Sapey T, Kabissa D, Fort E et al. Instant diagnosis of spontaneous bacterial peritonitis using leukocyte esterase reagent strips: Nephur-Test vs. MultistixSG.  Liver Int. 2005;  25 343-348
    Google Scholar
  • 50 Thevenot T, Cadranel J F, Nguyen-Khac E et al. Diagnosis of spontaneous bacterial peritonitis in cirrhotic patients by use of two reagent strips.  Eur J Gastroenterol Hepatol. 2004;  16 579-583
    Google Scholar
  • 51 Vanbiervliet G, Rakotoarisoa C, Filippi J et al. Diagnostic accuracy of a rapid urine-screening test (Multistix8SG) in cirrhotic patients with spontaneous bacterial peritonitis.  Eur J Gastroenterol Hepatol. 2002;  14 1257-1260
    Google Scholar
  • 52 Campillo B, Richardet J P, Dupeyron C. Diagnostic value of two reagent strips (Multistix 8 SG and Combur 2 LN) in cirrhotic patients with spontaneous bacterial peritonitis and symptomatic bacterascites.  Gastroenterol Clin Biol. 2006;  30 446-452
    Google Scholar
  • 53 Nousbaum J B, Cadranel J F, Nahon P et al. Diagnostic accuracy of the Multistix 8 SG reagent strip in diagnosis of spontaneous bacterial peritonitis.  Hepatology. 2007;  45 1275-1281
    Google Scholar
  • 54 Nguyen-Khac E, Cadranel J F, Thevenot T et al. Review article: the utility of reagent strips in the diagnosis of infected ascites in cirrhotic patients.  Aliment Pharmacol Ther. 2008;  28 282-288
    Google Scholar
  • 55 Runyon B A, Hoefs J C, Morgan T R. Ascitic fluid analysis in malignancy-related ascites.  Hepatology. 1988;  8 1104-1109
    Google Scholar
  • 56 Decker D, Stratmann H, Springer W et al. Benign and malignant cells in effusions: diagnostic value of image DNA cytometry in comparison to cytological analysis.  Pathol Res Pract. 1998;  194 791-795
    Google Scholar
  • 57 Jungst D, Gerbes A L, Martin R et al. Value of ascitic lipids in the differentiation between cirrhotic and malignant ascites.  Hepatology. 1986;  6 239-243
    Google Scholar
  • 58 Gerbes A L, Xie Y N, Mezger J et al. Ascitic fluid concentrations of fibronectin and cholesterol: comparison of differential diagnostic value with the conventional protein determination.  Liver. 1990;  10 152-157
    Google Scholar
  • 59 Gerbes A L, Jungst D, Xie Y N et al. Ascitic fluid analysis for the differentiation of malignancy-related and nonmalignant ascites. Proposal of a diagnostic sequence.  Cancer. 1991;  68 1808-1814
    Google Scholar
  • 60 Gulyas M, Kaposi A D, Elek G et al. Value of carcinoembryonic antigen (CEA) and cholesterol assays of ascitic fluid in cases of inconclusive cytology.  J Clin Pathol. 2001;  54 831-835
    Google Scholar
  • 61 Boyer T D, Kahn A M, Reynolds T B. Diagnostic value of ascitic fluid lactic dehydrogenase, protein, and WBC levels.  Arch Intern Med. 1978;  138 1103-1105
    Google Scholar
  • 62 Scholmerich J, Volk B A, Kottgen E et al. Fibronectin concentration in ascites differentiates between malignant and nonmalignant ascites.  Gastroenterology. 1984;  87 1160-1164
    Google Scholar
  • 63 Runyon B A. Elevated ascitic fluid fibronectin concentration. A non-specific finding.  J Hepatol. 1986;  3 219-222
    Google Scholar
  • 64 Chen S J, Wang S S, Lu C W et al. Clinical value of tumour markers and serum-ascites albumin gradient in the diagnosis of malignancy-related ascites.  J Gastroenterol Hepatol. 1994;  9 396-400
    Google Scholar
  • 65 Khandwalla H E, Fasakin Y, El-Serag H B. The utility of evaluating low serum albumin gradient ascites in patients with cirrhosis.  Am J Gastroenterol. 2009;  104 1401-1405
    Google Scholar
  • 66 Böcking A, Motherby H, Pomjanski N. Treffsicherheit der Ergusszytologie samt adjuvanten Untersuchungsmethoden.  Dtsch Ärztebl. 2000;  97 A-2626
    Google Scholar
  • 67 Feichter G, Dalquen P. Zytopathologie. Berlin: Springer; 2000
    Google Scholar
  • 68 Motherby H, Nadjari B, Friegel P et al. Diagnostic accuracy of effusion cytology.  Diagn Cytopathol. 1999;  20 350-357
    Google Scholar
  • 69 Rohn B L. Verbesserung der Treffsicherheit der Ergusszytologie mittels AgNOR-Analyse als adjuvante Untersuchungsmethode. Düsseldorf: Institut für Cytopathologie. Medizinische Fakultät der Heinrich-Heine Universität; 2004: 45
    Google Scholar
  • 70 Moore K P, Aithal G P. Guidelines on the management of ascites in cirrhosis.  Gut. 2006;  55 (Suppl 6) vi1-12
    Google Scholar
  • 71 Böcking A. DNA measurements: When and why?. In: Wied G L, Keebler C M, Rosenthal D L, eds Compendium on quality assurance, proficiency testing, and workload limitations. Tutorials of Cytology 1995.. Chicago IL; 1995: 170-188
    Google Scholar
  • 72 Schlake W, Kreipe H. Mitteilungen Deutsche Gesellschaft für Pathologie. Erklärung zur Zytopathologie.  . Unter Mitarbeit von: A. Böcking, R. Bollmann, S. Falk, V. Fritzsche, A. Wellmann. Pathologe. 2007;  28 393
    Google Scholar
  • 73 Spriggs A I, Boddington M M. The Cytology of Effusions in the Pleural, Pericardial and Peritoneal Cavities and of Cerebrospinal Fluid. 2nd ed. London: Heinemann; 1968
    Google Scholar
  • 74 Giroud F, Haroske G, Reith A et al. 1997 ESACP consensus report on diagnostic DNA image cytometry. Part II: Specific recommendations for quality assurance. European Society for Analytical Cellular Pathology.  Anal Cell Pathol. 1998;  17 201-208
    Google Scholar
  • 75 Haroske G, Giroud F, Reith A et al. 1997 ESACP consensus report on diagnostic DNA image cytometry. Part I: basic considerations and recommendations for preparation, measurement and interpretation. European Society for Analytical Cellular Pathology.  Anal Cell Pathol. 1998;  17 189-200
    Google Scholar
  • 76 Motherby H, Nadjari B, Remmerbach T et al. Static DNA cytometry as a diagnostic aid in effusion cytology: II. DNA aneuploidy for identification of neoplastic cells in equivocal effusions.  Anal Quant Cytol Histol. 1998;  20 162-168
    Google Scholar
  • 77 Pomjanski N, Motherby H, Buckstegge B et al. Early diagnosis of mesothelioma in serous effusions using AgNOR analysis.  Anal Quant Cytol Histol. 2001;  23 151-160
    Google Scholar
  • 78 Darwish Murad S, Plessier A, Hernandez-Guerra M et al. Etiology, management, and outcome of the Budd-Chiari syndrome.  Ann Intern Med. 2009;  151 167-175
    Google Scholar
  • 79 Valla D C. Budd-Chiari syndrome and veno-occlusive disease/sinusoidal obstruction syndrome.  Gut. 2008;  57 1469-1478
    Google Scholar
  • 80 Darwish Murad S, Valla D C, Groen P C et al. Determinants of survival and the effect of portosystemic shunting in patients with Budd-Chiari syndrome.  Hepatology. 2004;  39 500-508
    Google Scholar
  • 81 Menon K V, Shah de V, Kamath P S. The Budd-Chiari syndrome.  N Engl J Med. 2004;  350 578-585
    Google Scholar
  • 82 Ludwig J, Hashimoto E, McGill D B et al. Classification of hepatic venous outflow obstruction: ambiguous terminology of the Budd-Chiari syndrome.  Mayo Clin Proc. 1990;  65 51-55
    Google Scholar
  • 83 Okuda K, Kage M, Shrestha S M. Proposal of a new nomenclature for Budd-Chiari syndrome: hepatic vein thrombosis versus thrombosis of the inferior vena cava at its hepatic portion.  Hepatology. 1998;  28 1191-1198
    Google Scholar
  • 84 Hoekstra J, Leebeek F W, Plessier A et al. Paroxysmal nocturnal hemoglobinuria in Budd-Chiari syndrome: findings from a cohort study.  J Hepatol. 2009;  51 696-706
    Google Scholar
  • 85 Bolondi L, Gaiani S, Li Bassi S et al. Diagnosis of Budd-Chiari syndrome by pulsed Doppler ultrasound.  Gastroenterology. 1991;  100 1324-1331
    Google Scholar
  • 86 Miller W J, Federle M P, Straub W H et al. Budd-Chiari syndrome: imaging with pathologic correlation.  Abdom Imaging. 1993;  18 329-335
    Google Scholar
  • 87 Janssen H L, Garcia-Pagan J C, Elias E et al. Budd-Chiari syndrome: a review by an expert panel.  J Hepatol. 2003;  38 364-371
    Google Scholar
  • 88 Valla D, Casadevall N, Lacombe C et al. Primary myeloproliferative disorder and hepatic vein thrombosis. A prospective study of erythroid colony formation in vitro in 20 patients with Budd-Chiari syndrome.  Ann Intern Med. 1985;  103 329-334
    Google Scholar
  • 89 Valla D. Hepatic venous outflow tract obstruction etiopathogenesis: Asia versus the West.  J Gastroenterol Hepatol. 2004;  19 S204-S211
    Google Scholar
  • 90 Shulman H M, Fisher L B, Schoch H G et al. Veno-occlusive disease of the liver after marrow transplantation: histological correlates of clinical signs and symptoms.  Hepatology. 1994;  19 1171-1181
    Google Scholar
  • 91 Soriano G, Castellote J, Alvarez C et al. Secondary bacterial peritonitis in cirrhosis: a retrospective study of clinical and analytical characteristics, diagnosis and management.  J Hepatol. 2010;  52 39-44
    Google Scholar
  • 92 Caralis P V, Sprung C L, Schiff E R. Secondary bacterial peritonitis in cirrhotic patients with ascites.  South Med J. 1984;  77 579-583
    Google Scholar
  • 93 Runyon B A, Hoefs J C. Ascitic fluid analysis in the differentiation of spontaneous bacterial peritonitis from gastrointestinal tract perforation into ascitic fluid.  Hepatology. 1984;  4 447-450
    Google Scholar
  • 94 Akriviadis E A, Runyon B A. Utility of an algorithm in differentiating spontaneous from secondary bacterial peritonitis.  Gastroenterology. 1990;  98 127-133
    Google Scholar
  • 95 Garrison R N, Cryer H M, Howard D A et al. Clarification of risk factors for abdominal operations in patients with hepatic cirrhosis.  Ann Surg. 1984;  199 648-655
    Google Scholar
  • 96 Wu S S, Lin O S, Chen Y Y et al. Ascitic fluid carcinoembryonic antigen and alkaline phosphatase levels for the differentiation of primary from secondary bacterial peritonitis with intestinal perforation.  J Hepatol. 2001;  34 215-221
    Google Scholar
  • 97 Mullen K D. Review of the final report of the 1998 Working Party on definition, nomenclature and diagnosis of hepatic encephalopathy.  Aliment Pharmacol Ther. 2007;  25 Suppl 1 11-16
    Google Scholar
  • 98 Moreau R, Lebrec D. Diagnosis and treatment of acute renal failure in patients with cirrhosis.  Best Pract Res Clin Gastroenterol. 2007;  21 111-123
    Google Scholar
  • 99 D’Amico G, Morabito A, Pagliaro L et al. Survival and prognostic indicators in compensated and decompensated cirrhosis.  Dig Dis Sci. 1986;  31 468-475
    Google Scholar
  • 100 Guardiola J, Baliellas C, Xiol X et al. External validation of a prognostic model for predicting survival of cirrhotic patients with refractory ascites.  Am J Gastroenterol. 2002;  97 2374-2378
    Google Scholar
  • 101 Planas R, Montoliu S, Balleste B et al. Natural history of patients hospitalized for management of cirrhotic ascites.  Clin Gastroenterol Hepatol. 2006;  4 1385-1394
    Google Scholar
  • 102 Gines P, Cardenas A, Arroyo V et al. Management of cirrhosis and ascites.  N Engl J Med. 2004;  350 1646-1654
    Google Scholar
  • 103 Llovet J M, Planas R, Morillas R et al. Short-term prognosis of cirrhotics with spontaneous bacterial peritonitis: multivariate study.  Am J Gastroenterol. 1993;  88 388-392
    Google Scholar
  • 104 Peng S, Plank L D, McCall J L et al. Body composition, muscle function, and energy expenditure in patients with liver cirrhosis: a comprehensive study.  Am J Clin Nutr. 2007;  85 1257-1266
    Google Scholar
  • 105 Prijatmoko D, Strauss B J, Lambert J R et al. Early detection of protein depletion in alcoholic cirrhosis: role of body composition analysis.  Gastroenterology. 1993;  105 1839-1845
    Google Scholar
  • 106 Cabre E, Gonzalez-Huix F, Abad-Lacruz A et al. Effect of total enteral nutrition on the short-term outcome of severely malnourished cirrhotics. A randomized controlled trial.  Gastroenterology. 1990;  98 715-720
    Google Scholar
  • 107 Kearns P J, Young H, Garcia G et al. Accelerated improvement of alcoholic liver disease with enteral nutrition.  Gastroenterology. 1992;  102 200-205
    Google Scholar
  • 108 Caregaro L, Alberino F, Amodio P et al. Malnutrition in alcoholic and virus-related cirrhosis.  Am J Clin Nutr. 1996;  63 602-609
    Google Scholar
  • 109 Selberg O, Bottcher J, Tusch G et al. Identification of high- and low-risk patients before liver transplantation: a prospective cohort study of nutritional and metabolic parameters in 150 patients.  Hepatology. 1997;  25 652-657
    Google Scholar
  • 110 Pirlich M, Schutz T, Spachos T et al. Bioelectrical impedance analysis is a useful bedside technique to assess malnutrition in cirrhotic patients with and without ascites.  Hepatology. 2000;  32 1208-1215
    Google Scholar
  • 111 Selberg O, Selberg D. Norms and correlates of bioimpedance phase angle in healthy human subjects, hospitalized patients, and patients with liver cirrhosis.  Eur J Appl Physiol. 2002;  86 509-516
    Google Scholar
  • 112 Plauth M, Cabre E, Riggio O et al. ESPEN Guidelines on Enteral Nutrition: Liver disease.  Clin Nutr. 2006;  25 285-294
    Google Scholar
  • 113 Plauth M, Cabre E, Campillo B et al. ESPEN Guidelines on Parenteral Nutrition: hepatology.  Clin Nutr. 2009;  28 436-444
    Google Scholar
  • 114 Plauth M, Schutz T, Buckendahl D P et al. Weight gain after transjugular intrahepatic portosystemic shunt is associated with improvement in body composition in malnourished patients with cirrhosis and hypermetabolism.  J Hepatol. 2004;  40 228-233
    Google Scholar
  • 115 Plank L D, Gane E J, Peng S et al. Nocturnal nutritional supplementation improves total body protein status of patients with liver cirrhosis: a randomized 12-month trial.  Hepatology. 2008;  48 557-566
    Google Scholar
  • 116 Zillikens M C, Berg J W, Wattimena J L et al. Nocturnal oral glucose supplementation. The effects on protein metabolism in cirrhotic patients and in healthy controls.  J Hepatol. 1993;  17 377-383
    Google Scholar
  • 117 Cordoba van den J, Lopez-Hellin J, Planas M et al. Normal protein diet for episodic hepatic encephalopathy: results of a randomized study.  J Hepatol. 2004;  41 38-43
    Google Scholar
  • 118 Madden A M, Bradbury W, Morgan M Y. Taste perception in cirrhosis: its relationship to circulating micronutrients and food preferences.  Hepatology. 1997;  26 40-48
    Google Scholar
  • 119 Soulsby C T, Madden A M, Morgan M Y. The effect of dietary sodium restriction on energy and protein intake in patients with cirrhosis (Abstract).  Hepatology. 1997;  26 382A
    Google Scholar
  • 120 Chobanian A V, Bakris G L, Black H R et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure.  Hypertension. 2003;  42 1206-1252
    Google Scholar
  • 121 Mancia G, De Backer G, Dominiczak A et al. 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC).  J Hypertens. 2007;  25 1105-1187
    Google Scholar
  • 122 Reynolds T B, Lieberman F L, Goodman A R. Advantages of treatment of ascites without sodium restriction and without complete removal of excess fluid.  Gut. 1978;  19 549-553
    Google Scholar
  • 123 Gauthier A, Levy V G, Quinton A et al. Salt or no salt in the treatment of cirrhotic ascites: a randomised study.  Gut. 1986;  27 705-709
    Google Scholar
  • 124 Bernardi M, Laffi G, Salvagnini M et al. Efficacy and safety of the stepped care medical treatment of ascites in liver cirrhosis: a randomized controlled clinical trial comparing two diets with different sodium content.  Liver. 1993;  13 156-162
    Google Scholar
  • 125 Ring-Larsen H, Henriksen J H, Wilken C et al. Diuretic treatment in decompensated cirrhosis and congestive heart failure: effect of posture.  Br Med J (Clin Res Ed). 1986;  292 1351-1353
    Google Scholar
  • 126 Angeli P, Wong F, Watson H et al. Hyponatremia in cirrhosis: Results of a patient population survey.  Hepatology. 2006;  44 1535-1542
    Google Scholar
  • 127 Biggins S W, Kim W R, Terrault N A et al. Evidence-based incorporation of serum sodium concentration into MELD.  Gastroenterology. 2006;  130 1652-1660
    Google Scholar
  • 128 Hecker R, Sherlock S. Electrolyte and circulatory changes in terminal liver failure.  Lancet. 1956;  271 1121-1125
    Google Scholar
  • 129 Kim W R, Biggins S W, Kremers W K et al. Hyponatremia and mortality among patients on the liver-transplant waiting list.  N Engl J Med. 2008;  359 1018-1026
    Google Scholar
  • 130 Abbasoglu O, Goldstein R M, Vodapally M S et al. Liver transplantation in hyponatremic patients with emphasis on central pontine myelinolysis.  Clin Transplant. 1998;  12 263-269
    Google Scholar
  • 131 Sterns R H. Severe symptomatic hyponatremia: treatment and outcome. A study of 64 cases.  Ann Intern Med. 1987;  107 656-664
    Google Scholar
  • 132 Runyon B A. Management of adult patients with ascites due to cirrhosis: an update.  Hepatology. 2009;  49 2087-2107
    Google Scholar
  • 133 Descos L, Gauthier A, Levy V G et al. Comparison of six treatments of ascites in patients with liver cirrhosis. A clinical trial.  Hepatogastroenterology. 1983;  30 15-20
    Google Scholar
  • 134 Fogel M R, Sawhney V K, Neal E A et al. Diuresis in the ascitic patient: a randomized controlled trial of three regimens.  J Clin Gastroenterol. 1981;  3 (Suppl 1) 73-80
    Google Scholar
  • 135 Perez-Ayuso R M, Arroyo V, Planas R et al. Randomized comparative study of efficacy of furosemide versus spironolactone in nonazotemic cirrhosis with ascites. Relationship between the diuretic response and the activity of the renin-aldosterone system.  Gastroenterology. 1983;  84 961-968
    Google Scholar
  • 136 Santos J, Planas R, Pardo A et al. Spironolactone alone or in combination with furosemide in the treatment of moderate ascites in nonazotemic cirrhosis. A randomized comparative study of efficacy and safety.  J Hepatol. 2003;  39 187-192
    Google Scholar
  • 137 Pockros P J, Reynolds T B. Rapid diuresis in patients with ascites from chronic liver disease: the importance of peripheral edema.  Gastroenterology. 1986;  90 1827-1833
    Google Scholar
  • 138 Bernardi M, Servadei D, Trevisani F et al. Importance of plasma aldosterone concentration on the natriuretic effect of spironolactone in patients with liver cirrhosis and ascites.  Digestion. 1985;  31 189-193
    Google Scholar
  • 139 Gatta A, Angeli P, Caregaro L et al. A pathophysiological interpretation of unresponsiveness to spironolactone in a stepped-care approach to the diuretic treatment of ascites in nonazotemic cirrhotic patients.  Hepatology. 1991;  14 231-236
    Google Scholar
  • 140 Angeli P, Fasolato S, Mazza E et al. Combined versus sequential diuretic treatment of ascites in non-azotaemic patients with cirrhosis: results of an open randomised clinical trial.  Gut. 2010;  59 98-104
    Google Scholar
  • 141 Daskalopoulos G, Laffi G, Morgan T et al. Immediate effects of furosemide on renal hemodynamics in chronic liver disease with ascites.  Gastroenterology. 1987;  92 1859-1863
    Google Scholar
  • 142 Sawhney V K, Gregory P B, Swezey S E et al. Furosemide disposition in cirrhotic patients.  Gastroenterology. 1981;  81 1012-1016
    Google Scholar
  • 143 Stanley M M, Ochi S, Lee K K et al. Peritoneovenous shunting as compared with medical treatment in patients with alcoholic cirrhosis and massive ascites. Veterans Administration Cooperative Study on Treatment of Alcoholic Cirrhosis with Ascites.  N Engl J Med. 1989;  321 1632-1638
    Google Scholar
  • 144 Runyon B A. Care of patients with ascites.  N Engl J Med. 1994;  330 337-342
    Google Scholar
  • 145 Abecasis R, Guevara M, Miguez C et al. Long-term efficacy of torasemide compared with frusemide in cirrhotic patients with ascites.  Scand J Gastroenterol. 2001;  36 309-313
    Google Scholar
  • 146 Fiaccadori F, Pedretti G, Pasetti G et al. Torasemide versus furosemide in cirrhosis: a long-term, double-blind, randomized clinical study.  Clin Investig. 1993;  71 579-584
    Google Scholar
  • 147 Gerbes A L, Bertheau-Reith U, Falkner C et al. Advantages of the new loop diuretic torasemide over furosemide in patients with cirrhosis and ascites. A randomized, double blind cross-over trial.  J Hepatol. 1993;  17 353-358
    Google Scholar
  • 148 Angeli P, Dalla Pria M, De Bei E et al. Randomized clinical study of the efficacy of amiloride and potassium canrenoate in nonazotemic cirrhotic patients with ascites.  Hepatology. 1994;  19 72-79
    Google Scholar
  • 149 Ginsberg D J, Saad A, Gabuzda G J. Metabolic Studies with the Diuretic Triamterene in Patients with Cirrhosis and Ascites.  N Engl J Med. 1964;  271 1229-1235
    Google Scholar
  • 150 Knauf H, Mutschler E. Liver cirrhosis with ascites: pathogenesis of resistance to diuretics and long-term efficacy and safety of torasemide.  Cardiology. 1994;  84 (Suppl 2) 87-98
    Google Scholar
  • 151 McHutchison J G, Pinto P C, Reynolds T B. Hydrochlorothiazide as a third diuretic in cirrhosis with refractory ascites (Abstract).  Hepatology. 1989;  10 719
    Google Scholar
  • 152 Pitt B, Remme W, Zannad F et al. Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction.  N Engl J Med. 2003;  348 1309-1321
    Google Scholar
  • 153 Gines P, Wong F, Watson H et al. Effects of satavaptan, a selective vasopressin V(2) receptor antagonist, on ascites and serum sodium in cirrhosis with hyponatremia: a randomized trial.  Hepatology. 2008;  48 204-213
    Google Scholar
  • 154 Rosemurgy A S, Zervos E E, Clark W C et al. TIPS versus peritoneovenous shunt in the treatment of medically intractable ascites: a prospective randomized trial.  Ann Surg. 2004;  239 883-889 ; discussion 889 – 891
    Google Scholar
  • 155 Gines A, Fernandez-Esparrach G, Monescillo A et al. Randomized trial comparing albumin, dextran 70, and polygeline in cirrhotic patients with ascites treated by paracentesis.  Gastroenterology. 1996;  111 1002-1010
    Google Scholar
  • 156 Gines P, Tito L, Arroyo V et al. Randomized comparative study of therapeutic paracentesis with and without intravenous albumin in cirrhosis.  Gastroenterology. 1988;  94 1493-1502
    Google Scholar
  • 157 Pozzi M, Osculati G, Boari G et al. Time course of circulatory and humoral effects of rapid total paracentesis in cirrhotic patients with tense, refractory ascites.  Gastroenterology. 1994;  106 709-719
    Google Scholar
  • 158 Lebrec D, Giuily N, Hadengue A et al. Transjugular intrahepatic portosystemic shunts: comparison with paracentesis in patients with cirrhosis and refractory ascites: a randomized trial. French Group of Clinicians and a Group of Biologists.  J Hepatol. 1996;  25 135-144
    Google Scholar
  • 159 Wong F, Sniderman K, Liu P et al. Transjugular intrahepatic portosystemic stent shunt: effects on hemodynamics and sodium homeostasis in cirrhosis and refractory ascites.  Ann Intern Med. 1995;  122 816-822
    Google Scholar
  • 160 Gines P, Uriz J, Calahorra B et al. Transjugular intrahepatic portosystemic shunting versus paracentesis plus albumin for refractory ascites in cirrhosis.  Gastroenterology. 2002;  123 1839-1847
    Google Scholar
  • 161 Rossle M, Ochs A, Gulberg V et al. A comparison of paracentesis and transjugular intrahepatic portosystemic shunting in patients with ascites.  N Engl J Med. 2000;  342 1701-1707
    Google Scholar
  • 162 Salerno F, Camma C, Enea M et al. Transjugular intrahepatic portosystemic shunt for refractory ascites: a meta-analysis of individual patient data.  Gastroenterology. 2007;  133 825-834
    Google Scholar
  • 163 Sanyal A J, Genning C, Reddy K R et al. The North American Study for the Treatment of Refractory Ascites.  Gastroenterology. 2003;  124 634-641
    Google Scholar
  • 164 Salerno F, Merli M, Riggio O et al. Randomized controlled study of TIPS versus paracentesis plus albumin in cirrhosis with severe ascites.  Hepatology. 2004;  40 629-635
    Google Scholar
  • 165 Gulberg V, Liss I, Bilzer M et al. Improved quality of life in patients with refractory or recidivant ascites after insertion of transjugular intrahepatic portosystemic shunts.  Digestion. 2002;  66 127-130
    Google Scholar
  • 166 Bureau C, Garcia-Pagan J C, Otal P et al. Improved clinical outcome using polytetrafluoroethylene-coated stents for TIPS: results of a randomized study.  Gastroenterology. 2004;  126 469-475
    Google Scholar
  • 167 Albillos A, Banares R, Gonzalez M et al. A meta-analysis of transjugular intrahepatic portosystemic shunt versus paracentesis for refractory ascites.  J Hepatol. 2005;  43 990-996
    Google Scholar
  • 168 D’Amico G, Luca A, Morabito A et al. Uncovered transjugular intrahepatic portosystemic shunt for refractory ascites: a meta-analysis.  Gastroenterology. 2005;  129 1282-1293
    Google Scholar
  • 169 Deltenre P, Mathurin P, Dharancy S et al. Transjugular intrahepatic portosystemic shunt in refractory ascites: a meta-analysis.  Liver Int. 2005;  25 349-356
    Google Scholar
  • 170 Riggio O, Ridola L, Angeloni S et al. Clinical efficacy of transjugular intrahepatic portosystemic shunt created with covered stents with different diameters: results of a randomized controlled trial.  J Hepatol. 2010;  53 267-272
    Google Scholar
  • 171 Rossle M, Mullen K D. Long-term patency is expected with covered TIPS stents: this effect may not always be desirable!.  Hepatology. 2004;  40 495-497
    Google Scholar
  • 172 Rossle M, Gerbes A L. TIPS for the treatment of refractory ascites, hepatorenal syndrome and hepatic hydrothorax: a critical update.  Gut. 2010;  59 988-1000
    Google Scholar
  • 173 Chalasani N, Clark W S, Martin L G et al. Determinants of mortality in patients with advanced cirrhosis after transjugular intrahepatic portosystemic shunting.  Gastroenterology. 2000;  118 138-144
    Google Scholar
  • 174 Rajan D K, Haskal Z J, Clark T W. Serum bilirubin and early mortality after transjugular intrahepatic portosystemic shunts: results of a multivariate analysis.  J Vasc Interv Radiol. 2002;  13 155-161
    Google Scholar
  • 175 Gerbes A L, Gulberg V. Benefit of TIPS for patients with refractory or recidivant ascites: serum bilirubin may make the difference.  Hepatology. 2005;  41 217
    Google Scholar
  • 176 Cazzaniga M, Salerno F, Pagnozzi G et al. Diastolic dysfunction is associated with poor survival in patients with cirrhosis with transjugular intrahepatic portosystemic shunt.  Gut. 2007;  56 869-875
    Google Scholar
  • 177 Runyon B A. Monomicrobial nonneutrocytic bacterascites: a variant of spontaneous bacterial peritonitis.  Hepatology. 1990;  12 710-715
    Google Scholar
  • 178 Fernandez J, Navasa M, Gomez J et al. Bacterial infections in cirrhosis: epidemiological changes with invasive procedures and norfloxacin prophylaxis.  Hepatology. 2002;  35 140-148
    Google Scholar
  • 179 Castellote J, Girbau A, Maisterra S et al. Spontaneous bacterial peritonitis and bacterascites prevalence in asymptomatic cirrhotic outpatients undergoing large-volume paracentesis.  J Gastroenterol Hepatol. 2008;  23 256-259
    Google Scholar
  • 180 Conn H O, Fessel J M. Spontaneous bacterial peritonitis in cirrhosis: variations on a theme.  Medicine. 1971;  50 161-197
    Google Scholar
  • 181 Gines P, Rimola A, Planas R et al. Norfloxacin prevents spontaneous bacterial peritonitis recurrence in cirrhosis: results of a double-blind, placebo-controlled trial.  Hepatology. 1990;  12 716-724
    Google Scholar
  • 182 Tito L, Rimola A, Gines P et al. Recurrence of spontaneous bacterial peritonitis in cirrhosis: frequency and predictive factors.  Hepatology. 1988;  8 27-31
    Google Scholar
  • 183 Hsieh W J, Lin H C, Hwang S J et al. The effect of ciprofloxacin in the prevention of bacterial infection in patients with cirrhosis after upper gastrointestinal bleeding.  Am J Gastroenterol. 1998;  93 962-966
    Google Scholar
  • 184 Pauwels A, Mostefa-Kara N, Debenes B et al. Systemic antibiotic prophylaxis after gastrointestinal hemorrhage in cirrhotic patients with a high risk of infection.  Hepatology. 1996;  24 802-806
    Google Scholar
  • 185 Rolachon A, Cordier L, Bacq Y et al. Ciprofloxacin and long-term prevention of spontaneous bacterial peritonitis: results of a prospective controlled trial.  Hepatology. 1995;  22 1171-1174
    Google Scholar
  • 186 Soriano G, Guarner C, Teixido M et al. Selective intestinal decontamination prevents spontaneous bacterial peritonitis.  Gastroenterology. 1991;  100 477-481
    Google Scholar
  • 187 Terg R, Fassio E, Guevara M et al. Ciprofloxacin in primary prophylaxis of spontaneous bacterial peritonitis: a randomized, placebo-controlled study.  J Hepatol. 2008;  48 774-779
    Google Scholar
  • 188 Obstein K L, Campbell M S, Reddy K R et al. Association between model for end-stage liver disease and spontaneous bacterial peritonitis.  Am J Gastroenterol. 2007;  102 2732-2736
    Google Scholar
  • 189 Bajaj J S, Zadvornova Y, Heuman D M et al. Association of proton pump inhibitor therapy with spontaneous bacterial peritonitis in cirrhotic patients with ascites.  Am J Gastroenterol. 2009;  104 1130-1134
    Google Scholar
  • 190 Appenrodt B, Grunhage F, Gentemann M G et al. Nucleotide-binding oligomerization domain containing 2 (NOD2) variants are genetic risk factors for death and spontaneous bacterial peritonitis in liver cirrhosis.  Hepatology. 2010;  51 1327-1333
    Google Scholar
  • 191 Chu C M, Chang K Y, Liaw Y F. Prevalence and prognostic significance of bacterascites in cirrhosis with ascites.  Dig Dis Sci. 1995;  40 561-565
    Google Scholar
  • 192 Follo A, Llovet J M, Navasa M et al. Renal impairment after spontaneous bacterial peritonitis in cirrhosis: incidence, clinical course, predictive factors and prognosis.  Hepatology. 1994;  20 1495-1501
    Google Scholar
  • 193 Nobre S R, Cabral J E, Gomes J J et al. In-hospital mortality in spontaneous bacterial peritonitis: a new predictive model.  Eur J Gastroenterol Hepatol. 2008;  20 1176-1181
    Google Scholar
  • 194 Pinzello G, Simonetti R G, Craxi A et al. Spontaneous bacterial peritonitis: a prospective investigation in predominantly nonalcoholic cirrhotic patients.  Hepatology. 1983;  3 545-549
    Google Scholar
  • 195 Thuluvath P J, Morss S, Thompson R. Spontaneous bacterial peritonitis--in-hospital mortality, predictors of survival, and health care costs from 1988 to 1998.  Am J Gastroenterol. 2001;  96 1232-1236
    Google Scholar
  • 196 Toledo C, Salmeron J M, Rimola A et al. Spontaneous bacterial peritonitis in cirrhosis: predictive factors of infection resolution and survival in patients treated with cefotaxime.  Hepatology. 1993;  17 251-257
    Google Scholar
  • 197 Andreu M, Sola R, Sitges-Serra A et al. Risk factors for spontaneous bacterial peritonitis in cirrhotic patients with ascites.  Gastroenterology. 1993;  104 1133-1138
    Google Scholar
  • 198 Silvain C, Besson I, Ingrand P et al. Prognosis and long-term recurrence of spontaneous bacterial peritonitis in cirrhosis.  J Hepatol. 1993;  19 188-189
    Google Scholar
  • 199 Terg R, Levi D, Lopez P et al. Analysis of clinical course and prognosis of culture-positive spontaneous bacterial peritonitis and neutrocytic ascites. Evidence of the same disease.  Dig Dis Sci. 1992;  37 1499-1504
    Google Scholar
  • 200 Altman C, Grange J D, Amiot X et al. Survival after a first episode of spontaneous bacterial peritonitis. Prognosis of potential candidates for orthotopic liver transplantation.  J Gastroenterol Hepatol. 1995;  10 47-50
    Google Scholar
  • 201 Almdal T P, Skinhoj P. Spontaneous bacterial peritonitis in cirrhosis. Incidence, diagnosis, and prognosis.  Scand J Gastroenterol. 1987;  22 295-300
    Google Scholar
  • 202 Weinstein M P, Iannini P B, Stratton C W et al. Spontaneous bacterial peritonitis. A review of 28 cases with emphasis on improved survival and factors influencing prognosis.  Am J Med. 1978;  64 592-598
    Google Scholar
  • 203 Terg R, Gadano A, Cartier M et al. Serum creatinine and bilirubin predict renal failure and mortality in patients with spontaneous bacterial peritonitis: a retrospective study.  Liver Int. 2009;  29 415-419
    Google Scholar
  • 204 Franca A V, De Souza J B, Silva C M et al. Long-term prognosis of cirrhosis after spontaneous bacterial peritonitis treated with ceftriaxone.  J Clin Gastroenterol. 2001;  33 295-298
    Google Scholar
  • 205 Kamani L, Mumtaz K, Ahmed U S et al. Outcomes in culture positive and culture negative ascitic fluid infection in patients with viral cirrhosis: cohort study.  BMC Gastroenterol. 2008;  8 59
    Google Scholar
  • 206 Cho J H, Park K H, Kim S H et al. Bacteremia is a prognostic factor for poor outcome in spontaneous bacterial peritonitis.  Scand J Infect Dis. 2007;  39 697-702
    Google Scholar
  • 207 Alvarez R F, Mattos A A, Correa E B et al. Trimethoprim-sulfamethoxazole versus norfloxacin in the prophylaxis of spontaneous bacterial peritonitis in cirrhosis.  Arq Gastroenterol. 2005;  42 256-262
    Google Scholar
  • 208 Singh N, Gayowski T, Yu V L et al. Trimethoprim-sulfamethoxazole for the prevention of spontaneous bacterial peritonitis in cirrhosis: a randomized trial.  Ann Intern Med. 1995;  122 595-598
    Google Scholar
  • 209 Novella M, Sola R, Soriano G et al. Continuous versus inpatient prophylaxis of the first episode of spontaneous bacterial peritonitis with norfloxacin.  Hepatology. 1997;  25 532-536
    Google Scholar
  • 210 Fernandez J, Navasa M, Planas R et al. Primary prophylaxis of spontaneous bacterial peritonitis delays hepatorenal syndrome and improves survival in cirrhosis.  Gastroenterology. 2007;  133 818-824
    Google Scholar
  • 211 Grange J D, Roulot D, Pelletier G et al. Norfloxacin primary prophylaxis of bacterial infections in cirrhotic patients with ascites: a double-blind randomized trial.  J Hepatol. 1998;  29 430-436
    Google Scholar
  • 212 Loomba R, Wesley R, Bain A et al. Role of fluoroquinolones in the primary prophylaxis of spontaneous bacterial peritonitis: meta-analysis.  Clin Gastroenterol Hepatol. 2009;  7 487-493
    Google Scholar
  • 213 Saab S, Hernandez J C, Chi A C et al. Oral antibiotic prophylaxis reduces spontaneous bacterial peritonitis occurrence and improves short-term survival in cirrhosis: a meta-analysis.  Am J Gastroenterol. 2009;  104 993-1001 ; quiz 1002
    Google Scholar
  • 214 Krag A, Wiest R, Gluud L L. Fluoroquinolones in the primary prophylaxis of spontaneous bacterial peritonitis.  Am J Gastroenterol. 2010;  105 1444 ; author reply 1444 – 1445
    Google Scholar
  • 215 Lo R, Austin A S, Freeman J G. Antibiotic prophylaxis for the primary prevention of spontaneous bacterial peritonitis in cirrhotic patients with low ascitic protein: A meta-analysis.  J Hepatol. 2009;  50 S82
    Google Scholar
  • 216 Ortiz J, Vila M C, Soriano G et al. Infections caused by Escherichia coli resistant to norfloxacin in hospitalized cirrhotic patients.  Hepatology. 1999;  29 1064-1069
    Google Scholar
  • 217 Bajaj J S, Ananthakrishnan A N, Hafeezullah M et al. Clostridium difficile is associated with poor outcomes in patients with cirrhosis: A national and tertiary center perspective.  Am J Gastroenterol. 2010;  105 106-113
    Google Scholar
  • 218 Runyon B A. A pill a day can improve survival in patients with advanced cirrhosis.  Gastroenterology. 2007;  133 1029-1031
    Google Scholar
  • 219 Wade J J, Rolando N, Hayllar K et al. Bacterial and fungal infections after liver transplantation: an analysis of 284 patients.  Hepatology. 1995;  21 1328-1336
    Google Scholar
  • 220 Lontos S, Gow P J, Vaughan R B et al. Norfloxacin and trimethoprim-sulfamethoxazole therapy have similar efficacy in prevention of spontaneous bacterial peritonitis.  J Gastroenterol Hepatol. 2008;  23 252-255
    Google Scholar
  • 221 Terg R, Llano K, Cobas S M et al. Effects of oral ciprofloxacin on aerobic gram-negative fecal flora in patients with cirrhosis: results of short- and long-term administration, with daily and weekly dosages.  J Hepatol. 1998;  29 437-442
    Google Scholar
  • 222 Goulis J, Patch D, Burroughs A K. Bacterial infection in the pathogenesis of variceal bleeding.  Lancet. 1999;  353 139-142
    Google Scholar
  • 223 Bernard B, Cadranel J F, Valla D et al. Prognostic significance of bacterial infection in bleeding cirrhotic patients: a prospective study.  Gastroenterology. 1995;  108 1828-1834
    Google Scholar
  • 224 Goulis J, Armonis A, Patch D et al. Bacterial infection is independently associated with failure to control bleeding in cirrhotic patients with gastrointestinal hemorrhage.  Hepatology. 1998;  27 1207-1212
    Google Scholar
  • 225 Bernard B, Grange J D, Khac E N et al. Antibiotic prophylaxis for the prevention of bacterial infections in cirrhotic patients with gastrointestinal bleeding: a meta-analysis.  Hepatology. 1999;  29 1655-1661
    Google Scholar
  • 226 Chaves-Tapia N C, Barrientos-Gutierres T, Tellez-Avila F I et al. Antibiotic prophylaxis for cirrhotic patients with upper gastrointestinal bleeding.  Cochrane Database Syst Rev. 2010 Sep 8;  (9) CD002907
    Google Scholar
  • 227 Franchis de R. Evolving consensus in portal hypertension. Report of the Baveno IV consensus workshop on methodology of diagnosis and therapy in portal hypertension.  J Hepatol. 2005;  43 167-176
    Google Scholar
  • 228 Tuncer I, Topcu N, Durmus A et al. Oral ciprofloxacin versus intravenous cefotaxime and ceftriaxone in the treatment of spontaneous bacterial peritonitis.  Hepatogastroenterology. 2003;  50 1426-1430
    Google Scholar
  • 229 Navasa M, Follo A, Llovet J M et al. Randomized, comparative study of oral ofloxacin versus intravenous cefotaxime in spontaneous bacterial peritonitis.  Gastroenterology. 1996;  111 1011-1017
    Google Scholar
  • 230 Angeli P, Guarda S, Fasolato S et al. Switch therapy with ciprofloxacin vs. intravenous ceftazidime in the treatment of spontaneous bacterial peritonitis in patients with cirrhosis: similar efficacy at lower cost.  Aliment Pharmacol Ther. 2006;  23 75-84
    Google Scholar
  • 231 Taskiran B, Colakoglu O, Sozmen B et al. Comparison of cefotaxime and ofloxacin in treatment of spontaneous bacterial peritonitis.  Turk J Gastroenterol. 2004;  15 34-38
    Google Scholar
  • 232 Terg R, Cobas S, Fassio E et al. Oral ciprofloxacin after a short course of intravenous ciprofloxacin in the treatment of spontaneous bacterial peritonitis: results of a multicenter, randomized study.  J Hepatol. 2000;  33 564-569
    Google Scholar
  • 233 Park Y H, Lee H C, Song H G et al. Recent increase in antibiotic-resistant microorganisms in patients with spontaneous bacterial peritonitis adversely affects the clinical outcome in Korea.  J Gastroenterol Hepatol. 2003;  18 927-933
    Google Scholar
  • 234 Singh N, Wagener M M, Gayowski T. Changing epidemiology and predictors of mortality in patients with spontaneous bacterial peritonitis at a liver transplant unit.  Clin Microbiol Infect. 2003;  9 531-537
    Google Scholar
  • 235 Kresken M, Hafner D, Schmitz F J et al. PEG-Resistenzstudie: Resistenzsituation bei klinisch wichtigen Infektionserregern gegenüber Antibiotika in Deutschland und im mitteleuropäischen Raum. Paul-Ehrlich-Gesellschaft für Chemotherapie e.V; 2007
    Google Scholar
  • 236 Kresken M, Hafner D, Schmitz F J et al. PEG-Resistenzstudie: Daten zur Resistenzlage bei klinisch wichtigen Bakterienspezies gegenüber Antibiotika in Mitteleuropa. Paul-Ehrlich-Gesellschaft für Chemotherapie e.V; 2010
    Google Scholar
  • 237 Felisart J, Rimola A, Arroyo V et al. Cefotaxime is more effective than is ampicillin-tobramycin in cirrhotics with severe infections.  Hepatology. 1985;  5 457-462
    Google Scholar
  • 238 Rimola A, Salmeron J M, Clemente G et al. Two different dosages of cefotaxime in the treatment of spontaneous bacterial peritonitis in cirrhosis: results of a prospective, randomized, multicenter study.  Hepatology. 1995;  21 674-679
    Google Scholar
  • 239 Rimola A, Navasa M, Arroyo V. Experience with cefotaxime in the treatment of spontaneous bacterial peritonitis in cirrhosis.  Diagn Microbiol Infect Dis. 1995;  22 141-145
    Google Scholar
  • 240 Gomez-Jimenez J, Ribera E, Gasser I et al. Randomized trial comparing ceftriaxone with cefonicid for treatment of spontaneous bacterial peritonitis in cirrhotic patients.  Antimicrob Agents Chemother. 1993;  37 1587-1592
    Google Scholar
  • 241 Ricart E, Soriano G, Novella M T et al. Amoxicillin-clavulanic acid versus cefotaxime in the therapy of bacterial infections in cirrhotic patients.  J Hepatol. 2000;  32 596-602
    Google Scholar
  • 242 Acevedo J C, Fernandez J, Castro M et al. Current efficacy of recommended empirical antibiotic therapy in patients with cirrhosis and bacterial infection (Abstract).  J Hepatol. 2009;  50 S5
    Google Scholar
  • 243 Castellote J, Ariza X, Girbau A et al. Risk factors to cefotaxime-resistant spontaneous bacterial peritonitis (Abstract).  J Hepatol. 2010;  52 S69
    Google Scholar
  • 244 Angeloni S, Leboffe C, Parente A et al. Efficacy of current guidelines for the treatment of spontaneous bacterial peritonitis in the clinical practice.  World J Gastroenterol. 2008;  14 2757-2762
    Google Scholar
  • 245 Yakar T, Guclu M, Serin E et al. A recent evaluation of empirical cephalosporin treatment and antibiotic resistance of changing bacterial profiles in spontaneous bacterial peritonitis.  Dig Dis Sci. 2010;  55 1149-1154
    Google Scholar
  • 246 Castellote J, Ariza X, Girbau A et al. Antibiotic-resistant bacteria in spontaneous bacterial peritonitis. Is it time to change? (Abstract).  J Hepatol. 2010;  52 S69
    Google Scholar
  • 247 Cheong H S, Kang C I, Lee J A et al. Clinical significance and outcome of nosocomial acquisition of spontaneous bacterial peritonitis in patients with liver cirrhosis.  Clin Infect Dis. 2009;  48 1230-1236
    Google Scholar
  • 248 Dupeyron C, Mangeney N, Sedrati L et al. Rapid emergence of quinolone resistance in cirrhotic patients treated with norfloxacin to prevent spontaneous bacterial peritonitis.  Antimicrob Agents Chemother. 1994;  38 340-344
    Google Scholar
  • 249 Dupeyron C, Campillo S B, Mangeney N et al. Carriage of Staphylococcus aureus and of gram-negative bacilli resistant to third-generation cephalosporins in cirrhotic patients: a prospective assessment of hospital-acquired infections.  Infect Control Hosp Epidemiol. 2001;  22 427-432
    Google Scholar
  • 250 Campillo B, Dupeyron C, Richardet J P et al. Epidemiology of severe hospital-acquired infections in patients with liver cirrhosis: effect of long-term administration of norfloxacin.  Clin Infect Dis. 1998;  26 1066-1070
    Google Scholar
  • 251 Campillo B, Dupeyron C, Richardet J P. Epidemiology of hospital-acquired infections in cirrhotic patients: effect of carriage of methicillin-resistant Staphylococcus aureus and influence of previous antibiotic therapy and norfloxacin prophylaxis.  Epidemiol Infect. 2001;  127 443-450
    Google Scholar
  • 252 Song K H, Jeon J H, Park W B et al. Clinical outcomes of spontaneous bacterial peritonitis due to extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella species: a retrospective matched case-control study.  BMC Infect Dis. 2009;  9 41
    Google Scholar
  • 253 Umgelter A, Reindl W, Miedaner M et al. Failure of current antibiotic first-line regimens and mortality in hospitalized patients with spontaneous bacterial peritonitis.  Infection. 2009;  37 2-8
    Google Scholar
  • 254 Chavez-Tapia N C, Soares-Weiser K, Brezis M et al. Antibiotics for spontaneous bacterial peritonitis in cirrhotic patients.  Cochrane Database Syst Rev. 2009;  CD002232
    Google Scholar
  • 255 Chen T A, Lo G H, Lai K H et al. Single daily amikacin versus cefotaxime in the short-course treatment of spontaneous bacterial peritonitis in cirrhotics.  World J Gastroenterol. 2005;  11 6823-6827
    Google Scholar
  • 256 Rastegar L A, Umrani G, Dehbashi N et al. Evaluation of the therapeutic effect of pefloxacin in comparison with ampicillin and gentamicin in cirrhotic patients with spontaneous bacterial peritonitis.  Hepatogastroenterology. 1998;  45 783-785
    Google Scholar
  • 257 Antillon M R, Runyon B A. Effect of marked peripheral leukocytosis on the leukocyte count in ascites.  Arch Intern Med. 1991;  151 509-510
    Google Scholar
  • 258 Ljubicic N, Spajic D, Vrkljan M M et al. The value of ascitic fluid polymorphonuclear cell count determination during therapy of spontaneous bacterial peritonitis in patients with liver cirrhosis.  Hepatogastroenterology. 2000;  47 1360-1363
    Google Scholar
  • 259 Runyon B A, Hoefs J C. Spontaneous vs secondary bacterial peritonitis. Differentiation by response of ascitic fluid neutrophil count to antimicrobial therapy.  Arch Intern Med. 1986;  146 1563-1565
    Google Scholar
  • 260 Fong T L, Akriviadis E A, Runyon B A et al. Polymorphonuclear cell count response and duration of antibiotic therapy in spontaneous bacterial peritonitis.  Hepatology. 1989;  9 423-426
    Google Scholar
  • 261 Runyon B A, McHutchison J G, Antillon M R et al. Short-course versus long-course antibiotic treatment of spontaneous bacterial peritonitis. A randomized controlled study of 100 patients.  Gastroenterology. 1991;  100 1737-1742
    Google Scholar
  • 262 Bauer T M, Follo A, Navasa M et al. Daily norfloxacin is more effective than weekly rufloxacin in prevention of spontaneous bacterial peritonitis recurrence.  Dig Dis Sci. 2002;  47 1356-1361
    Google Scholar
  • 263 Arroyo V, Gines P, Gerbes A L et al. Definition and diagnostic criteria of refractory ascites and hepatorenal syndrome in cirrhosis. International Ascites Club.  Hepatology. 1996;  23 164-176
    Google Scholar
  • 264 Salerno F, Gerbes A, Gines P et al. Diagnosis, prevention and treatment of hepatorenal syndrome in cirrhosis.  Gut. 2007;  56 1310-1318
    Google Scholar
  • 265 Solanki P, Chawla A, Garg R et al. Beneficial effects of terlipressin in hepatorenal syndrome: a prospective, randomized placebo-controlled clinical trial.  J Gastroenterol Hepatol. 2003;  18 152-156
    Google Scholar
  • 266 Sanyal A J, Boyer T, Garcia-Tsao G et al. A randomized, prospective, double-blind, placebo-controlled trial of terlipressin for type 1 hepatorenal syndrome.  Gastroenterology. 2008;  134 1360-1368
    Google Scholar
  • 267 Martin-Llahi M, Pepin M N, Guevara M et al. Terlipressin and albumin vs albumin in patients with cirrhosis and hepatorenal syndrome: a randomized study.  Gastroenterology. 2008;  134 1352-1359
    Google Scholar
  • 268 Neri S, Pulvirenti D, Malaguarnera M et al. Terlipressin and albumin in patients with cirrhosis and type I hepatorenal syndrome.  Dig Dis Sci. 2008;  53 830-835
    Google Scholar
  • 269 Ortega R, Gines P, Uriz J et al. Terlipressin therapy with and without albumin for patients with hepatorenal syndrome: results of a prospective, nonrandomized study.  Hepatology. 2002;  36 941-948
    Google Scholar
  • 270 Saner F, Kavuk I, Lang H et al. Terlipressin and gelafundin: safe therapy of hepatorenal syndrome.  Eur J Med Res. 2004;  9 78-82
    Google Scholar
  • 271 Dart A B, Mutter T C, Ruth C A et al. Hydroxyethyl starch (HES) versus other fluid therapies: effects on kidney function.  Cochrane Database Syst Rev. 2010;  CD007594
    Google Scholar
  • 272 Fabrizi F, Dixit V, Messa P et al. Terlipressin for hepatorenal syndrome: A meta-analysis of randomized trials.  Int J Artif Organs. 2009;  32 133-140
    Google Scholar
  • 273 Gluud L L, Christensen K, Christensen E et al. Systematic review of randomized trials on vasoconstrictor drugs for hepatorenal syndrome.  Hepatology. 2010;  51 576-584
    Google Scholar
  • 274 Sagi S V, Mittal S, Kasturi K S et al. Terlipressin therapy for reversal of type 1 hepatorenal syndrome: a meta-analysis of randomized controlled trials.  J Gastroenterol Hepatol. 2010;  25 880-885
    Google Scholar
  • 275 Gerbes A L, Huber E, Gulberg V. Terlipressin for hepatorenal syndrome: continuous infusion as an alternative to i. v. bolus administration.  Gastroenterology. 2009;  137 1179 ; author reply 1179 – 1181
    Google Scholar
  • 276 Hadengue A, Gadano A, Moreau R et al. Beneficial effects of the 2-day administration of terlipressin in patients with cirrhosis and hepatorenal syndrome.  J Hepatol. 1998;  29 565-570
    Google Scholar
  • 277 Gerbes A L, Gulberg V, Waggershauser T et al. Renal effects of transjugular intrahepatic portosystemic shunt in cirrhosis: comparison of patients with ascites, with refractory ascites, or without ascites.  Hepatology. 1998;  28 683-688
    Google Scholar
  • 278 Guevara M, Gines P, Bandi J C et al. Transjugular intrahepatic portosystemic shunt in hepatorenal syndrome: effects on renal function and vasoactive systems.  Hepatology. 1998;  28 416-422
    Google Scholar
  • 279 Brensing K A, Textor J, Perz J et al. Long term outcome after transjugular intrahepatic portosystemic stent-shunt in non-transplant cirrhotics with hepatorenal syndrome: a phase II study.  Gut. 2000;  47 288-295
    Google Scholar
  • 280 Wong F, Pantea L, Sniderman K. Midodrine, octreotide, albumin, and TIPS in selected patients with cirrhosis and type 1 hepatorenal syndrome.  Hepatology. 2004;  40 55-64
    Google Scholar
  • 281 Testino G, Ferro C, Sumberaz A et al. Type-2 hepatorenal syndrome and refractory ascites: role of transjugular intrahepatic portosystemic stent-shunt in eighteen patients with advanced cirrhosis awaiting orthotopic liver transplantation.  Hepatogastroenterology. 2003;  50 1753-1755
    Google Scholar
  • 282 Witzke O, Baumann M, Patschan D et al. Which patients benefit from hemodialysis therapy in hepatorenal syndrome?.  J Gastroenterol Hepatol. 2004;  19 1369-1373
    Google Scholar
  • 283 Mitzner S R, Stange J, Klammt S et al. Improvement of hepatorenal syndrome with extracorporeal albumin dialysis MARS: results of a prospective, randomized, controlled clinical trial.  Liver Transpl. 2000;  6 277-286
    Google Scholar
  • 284 Wong F, Raina N, Richardson R. Molecular adsorbent recirculating system is ineffective in the management of type 1 hepatorenal syndrome in patients with cirrhosis with ascites who have failed vasoconstrictor treatment.  Gut. 2010;  59 381-386
    Google Scholar
  • 285 Bannares R, Nevens F, Larsen F S et al. Extracorporeal liver support with the molecular adsorbent recirculating system (MARS) in patients with acute-on-chronic liver failure (AOCLF). The RELIEF trail (Abstract).  J Hepatol. 2010;  52 S459-S460
    Google Scholar
  • 286 Rifai K, Ernst T, Kretschmer U et al. Prometheus – a new extracorporeal system for the treatment of liver failure.  J Hepatol. 2003;  39 984-990
    Google Scholar
  • 287 Rifai K, Kribben A, Gerken G et al. Extracorporeal liver support by fractionated plasma separation and adsorption (Prometheus) in patients with acute-on-chronic liver failure (HELIOS study): A prospective randomized controlled multicenter study (Abstract).  J Hepatol. 2010;  52 S3
    Google Scholar
  • 288 Gonwa T A, Poplawski S, Paulsen W et al. Pathogenesis and outcome of hepatorenal syndrome in patients undergoing orthotopic liver transplant.  Transplantation. 1989;  47 395-397
    Google Scholar
  • 289 Seu P, Wilkinson A H, Shaked A et al. The hepatorenal syndrome in liver transplant recipients.  Am Surg. 1991;  57 806-809
    Google Scholar
  • 290 Lafayette R A, Pare G, Schmid C H et al. Pretransplant renal dysfunction predicts poorer outcome in liver transplantation.  Clin Nephrol. 1997;  48 159-164
    Google Scholar
  • 291 Restuccia T, Ortega R, Guevara M et al. Effects of treatment of hepatorenal syndrome before transplantation on posttransplantation outcome. A case-control study.  J Hepatol. 2004;  40 140-146
    Google Scholar
  • 292 Bundesärztekammer . Richtlinien zur Organtransplantation gem. § 16 Abs.1 S.1 Nrn. 2, 4 u. 5 TPG.  Dtsch Ärztebl. 2010;  107 A1532-1541
    Google Scholar
  • 293 Davis C L, Feng S, Sung R et al. Simultaneous liver-kidney transplantation: evaluation to decision making.  Am J Transplant. 2007;  7 1702-1709
    Google Scholar
  • 294 Lieberman F L, Hidemura R, Peters R L et al. Pathogenesis and treatment of hydrothorax complicating cirrhosis with ascites.  Ann Intern Med. 1966;  64 341-351
    Google Scholar
  • 295 Malagari K, Nikita A, Alexopoulou E et al. Cirrhosis-related intrathoracic disease. Imaging features in 1038 patients.  Hepatogastroenterology. 2005;  52 558-562
    Google Scholar
  • 296 Kinasewitz G T, Keddissi J I. Hepatic hydrothorax.  Curr Opin Pulm Med. 2003;  9 261-265
    Google Scholar
  • 297 Kiafar C, Gilani N. Hepatic hydrothorax: current concepts of pathophysiology and treatment options.  Ann Hepatol. 2008;  7 313-320
    Google Scholar
  • 298 Halank M, Strassburg C P, Hoeper M M. Pulmonary complications of liver cirrhosis: hepatopulmonary syndrome, portopulmonary hypertension and hepatic hydrothorax.  Internist. 2010;  51 (Suppl 1) 255-263
    Google Scholar
  • 299 Cardenas A, Arroyo V. Management of ascites and hepatic hydrothorax.  Best Pract Res Clin Gastroenterol. 2007;  21 55-75
    Google Scholar
  • 300 Cardenas A, Kelleher T, Chopra S. Review article: hepatic hydrothorax.  Aliment Pharmacol Ther. 2004;  20 271-279
    Google Scholar
  • 301 Huang P M, Chang Y L, Yang C Y et al. The morphology of diaphragmatic defects in hepatic hydrothorax: thoracoscopic finding.  J Thorac Cardiovasc Surg. 2005;  130 141-145
    Google Scholar
  • 302 Rubinstein D, McInnes I E, Dudley F J. Hepatic hydrothorax in the absence of clinical ascites: diagnosis and management.  Gastroenterology. 1985;  88 188-191
    Google Scholar
  • 303 Xiol X, Castellote J, Cortes-Beut R et al. Usefulness and complications of thoracentesis in cirrhotic patients.  Am J Med. 2001;  111 67-69
    Google Scholar
  • 304 Reissig A, Heyne J P, Kroegel C. Ancillary lung parenchymal findings at spiral CT scanning in pulmonary embolism. Relationship to chest sonography.  Eur J Radiol. 2004;  49 250-257
    Google Scholar
  • 305 Kocijancic I, Vidmar K, Ivanovi-Herceg Z. Chest sonography versus lateral decubitus radiography in the diagnosis of small pleural effusions.  J Clin Ultrasound. 2003;  31 69-74
    Google Scholar
  • 306 Kohan J M, Poe R H, Israel R H et al. Value of chest ultrasonography versus decubitus roentgenography for thoracentesis.  Am Rev Respir Dis. 1986;  133 1124-1126
    Google Scholar
  • 307 Light R W. Clinical practice. Pleural effusion.  N Engl J Med. 2002;  346 1971-1977
    Google Scholar
  • 308 Castellote J, Xiol X, Cortes-Beut R et al. Complications of thoracentesis in cirrhotic patients with pleural effusion.  Rev Esp Enferm Dig. 2001;  93 566-575
    Google Scholar
  • 309 Jones P W, Moyers J P, Rogers J T et al. Ultrasound-guided thoracentesis: is it a safer method?.  Chest. 2003;  123 418-423
    Google Scholar
  • 310 Gordon C E, Feller-Kopman D, Balk E M et al. Pneumothorax following thoracentesis: a systematic review and meta-analysis.  Arch Intern Med. 2010;  170 332-339
    Google Scholar
  • 311 Romero S, Candela A, Martin C et al. Evaluation of different criteria for the separation of pleural transudates from exudates.  Chest. 1993;  104 399-404
    Google Scholar
  • 312 Burgess L J, Maritz F J, Taljaard J J. Comparative analysis of the biochemical parameters used to distinguish between pleural transudates and exudates.  Chest. 1995;  107 1604-1609
    Google Scholar
  • 313 Light R W, Macgregor M I, Luchsinger P C et al. Pleural effusions: the diagnostic separation of transudates and exudates.  Ann Intern Med. 1972;  77 507-513
    Google Scholar
  • 314 Mittal B R, Maini A, Das B K. Peritoneopleural communication associated with cirrhotic ascites: scintigraphic demonstration.  Abdom Imaging. 1996;  21 69-70
    Google Scholar
  • 315 Bhattacharya A, Mittal B R, Biswas T et al. Radioisotope scintigraphy in the diagnosis of hepatic hydrothorax.  J Gastroenterol Hepatol. 2001;  16 317-321
    Google Scholar
  • 316 Ajmi S, Hassine H, Guezguez M et al. Isotopic exploration of hepatic hydrothorax: ten cases.  Gastroenterol Clin Biol. 2004;  28 462-466
    Google Scholar
  • 317 Huang P M, Han Y Y, Kuo S W et al. Color Doppler ultrasonography in detecting transdiaphragmatic flow of hepatic hydrothorax: correlation with thoracoscopic findings.  J Thorac Cardiovasc Surg. 2009;  138 1251-1252
    Google Scholar
  • 318 Tamano M, Hashimoto T, Kojima K et al. Diagnosis of hepatic hydrothorax using contrast-enhanced ultrasonography with intraperitoneal injection of Sonazoid.  J Gastroenterol Hepatol. 2010;  25 383-386
    Google Scholar
  • 319 Takayama T, Kurokawa Y, Kaiwa Y et al. A new technique of thoracoscopic pleurodesis for refractory hepatic hydrothorax.  Surg Endosc. 2004;  18 140-143
    Google Scholar
  • 320 Lin D J, Zhang M, Gao G X et al. Thoracoscopy for diagnosis and management of refractory hepatic hydrothorax.  Chin Med J. 2006;  119 430-434
    Google Scholar
  • 321 Xiol X, Castellvi J M, Guardiola J et al. Spontaneous bacterial empyema in cirrhotic patients: a prospective study.  Hepatology. 1996;  23 719-723
    Google Scholar
  • 322 D"Amico G, Garcia-Tsao G, Pagliaro L. Natural history and prognostic indicators of survival in cirrhosis: a systematic review of 118 studies.  J Hepatol. 2006;  44 217-231
    Google Scholar
  • 323 Kaplan L M, Epstein S K, Schwartz S L et al. Clinical, echocardiographic, and hemodynamic evidence of cardiac tamponade caused by large pleural effusions.  Am J Respir Crit Care Med. 1995;  151 904-908
    Google Scholar
  • 324 Angueira C E, Kadakia S C. Effects of large-volume paracentesis on pulmonary function in patients with tense cirrhotic ascites.  Hepatology. 1994;  20 825-828
    Google Scholar
  • 325 Heller B J, Grathwohl M K. Contralateral reexpansion pulmonary edema.  South Med J. 2000;  93 828-831
    Google Scholar
  • 326 Feller-Kopman D, Berkowitz D, Boiselle P et al. Large-volume thoracentesis and the risk of reexpansion pulmonary edema.  Ann Thorac Surg. 2007;  84 1656-1661
    Google Scholar
  • 327 Liu L U, Haddadin H A, Bodian C A et al. Outcome analysis of cirrhotic patients undergoing chest tube placement.  Chest. 2004;  126 142-148
    Google Scholar
  • 328 Colombato L. The role of transjugular intrahepatic portosystemic shunt (TIPS) in the management of portal hypertension.  J Clin Gastroenterol. 2007;  41 (Suppl 3) S344-S351
    Google Scholar
  • 329 Strauss R M, Martin L G, Kaufman S L et al. Transjugular intrahepatic portal systemic shunt for the management of symptomatic cirrhotic hydrothorax.  Am J Gastroenterol. 1994;  89 1520-1522
    Google Scholar
  • 330 Chalasani N, Gitlin N. TIPS for patients with refractory hepatic hydrothorax: what is the take-home message?.  Am J Gastroenterol. 1997;  92 2129-2130
    Google Scholar
  • 331 Gordon F D, Anastopoulos H T, Crenshaw W et al. The successful treatment of symptomatic, refractory hepatic hydrothorax with transjugular intrahepatic portosystemic shunt.  Hepatology. 1997;  25 1366-1369
    Google Scholar
  • 332 Degawa M, Hamasaki K, Yano K et al. Refractory hepatic hydrothorax treated with transjugular intrahepatic portosystemic shunt.  J Gastroenterol. 1999;  34 128-131
    Google Scholar
  • 333 Conklin L D, Estrera A L, Weiner M A et al. Transjugular intrahepatic portosystemic shunt for recurrent hepatic hydrothorax.  Ann Thorac Surg. 2000;  69 609-611
    Google Scholar
  • 334 Siegerstetter V, Deibert P, Ochs A et al. Treatment of refractory hepatic hydrothorax with transjugular intrahepatic portosystemic shunt: long-term results in 40 patients.  Eur J Gastroenterol Hepatol. 2001;  13 529-534
    Google Scholar
  • 335 Spencer E B, Cohen D T, Darcy M D. Safety and efficacy of transjugular intrahepatic portosystemic shunt creation for the treatment of hepatic hydrothorax.  J Vasc Interv Radiol. 2002;  13 385-390
    Google Scholar
  • 336 Wilputte J Y, Goffette P, Zech F et al. The outcome after transjugular intrahepatic portosystemic shunt (TIPS) for hepatic hydrothorax is closely related to liver dysfunction: a long-term study in 28 patients.  Acta Gastroenterol Belg. 2007;  70 6-10
    Google Scholar
  • 337 Dhanasekaran R, West J K, Gonzales P C et al. Transjugular intrahepatic portosystemic shunt for symptomatic refractory hepatic hydrothorax in patients with cirrhosis.  Am J Gastroenterol. 2010;  105 635-641
    Google Scholar
  • 338 Ikard R W, Sawyers J L. Persistent hepatic hydrothorax after peritoneojugular shunt.  Arch Surg. 1980;  115 1125-1127
    Google Scholar
  • 339 Ghandour E, Carter J, Feola M et al. Management of hepatic hydrothorax with a peritoneovenous (Denver) shunt.  South Med J. 1990;  83 718-719
    Google Scholar
  • 340 Falchuk K R, Jacoby I, Colucci W S et al. Tetracycline-induced pleural symphysis for recurrent hydrothorax complicating cirrhosis. A new approach to treatment.  Gastroenterology. 1977;  72 319-321
    Google Scholar
  • 341 Milanez Campos J R, Filho L O, Campos Werebe de E et al. Thoracoscopy and talc poudrage in the management of hepatic hydrothorax.  Chest. 2000;  118 13-17
    Google Scholar
  • 342 Ferrante D, Arguedas de M R, Cerfolio R J et al. Video-assisted thoracoscopic surgery with talc pleurodesis in the management of symptomatic hepatic hydrothorax.  Am J Gastroenterol. 2002;  97 3172-3175
    Google Scholar
  • 343 Cerfolio R J, Bryant A S. Efficacy of video-assisted thoracoscopic surgery with talc pleurodesis for porous diaphragm syndrome in patients with refractory hepatic hydrothorax.  Ann Thorac Surg. 2006;  82 457-459
    Google Scholar
  • 344 Huang P M, Kuo S W, Lee J M. Thoracoscopic diaphragmatic repair for refractory hepatic hydrothorax: application of pleural flap and mesh onlay reinforcement.  Thorac Cardiovasc Surg. 2006;  54 47-50
    Google Scholar
  • 345 Xiol X, Tremosa G, Castellote J et al. Liver transplantation in patients with hepatic hydrothorax.  Transpl Int. 2005;  18 672-675
    Google Scholar
  • 346 Serste T, Moreno C, Francoz C et al. The impact of preoperative hepatic hydrothorax on the outcome of adult liver transplantation.  Eur J Gastroenterol Hepatol. 2010;  22 207-212
    Google Scholar
  • 347 Sese E, Xiol X, Castellote J et al. Low complement levels and opsonic activity in hepatic hydrothorax: its relationship with spontaneous bacterial empyema.  J Clin Gastroenterol. 2003;  36 75-77
    Google Scholar
  • 348 Ackerman Z, Reynolds T B. Evaluation of pleural fluid in patients with cirrhosis.  J Clin Gastroenterol. 1997;  25 619-622
    Google Scholar
  • 349 Xiol X, Castellote J, Baliellas C et al. Spontaneous bacterial empyema in cirrhotic patients: analysis of eleven cases.  Hepatology. 1990;  11 365-370
    Google Scholar
  • 350 Castellote J, Lopez C, Gornals J et al. Use of reagent strips for the rapid diagnosis of spontaneous bacterial empyema.  J Clin Gastroenterol. 2005;  39 278-281
    Google Scholar
  • 351 Hoffken G, Lorenz J, Kern W et al. Epidemiology, diagnosis, antimicrobial therapy and management of community-acquired pneumonia and lower respiratory tract infections in adults. Guidelines of the Paul-Ehrlich-Society for Chemotherapy, the German Respiratory Society, the German Society for Infectiology and the Competence Network CAPNETZ Germany.  Pneumologie. 2009;  63 e1-68
    Google Scholar
  • 352 Maskell N A, Davies C W, Nunn A J et al. U.K. Controlled trial of intrapleural streptokinase for pleural infection.  N Engl J Med. 2005;  352 865-874
    Google Scholar

Prof. Dr. Alexander L. Gerbes

Med. Klinik und Poliklinik 2, Leber Centrum München, Klinikum der LMU München

Marchioninistr. 15

81377 München

Email: sekretariat.gerbes@med.uni-muenchen.de