P169 Long term abdominal drain for palliation in advance liver cirrhosis: survey of risks & barriers

Abstract

<46 mg/g. Median time (IQR) to repeat 35d (22-74.) 70 results 100-249 mg/g indicated routine referral; median wait for review 83d (54-160.) 130 results !250 mg/g indicated urgent referral; median wait 59d (40-105.) 18% had endoscopy directly ('straight to test.') 16% of results <46 ug/g still referred.Conclusions This is the largest analysis of UK primary care FC testing to date that considers IBD specifically, as opposed to any organic intestinal disease, versus IBS. Comparing favourably to other published work, the assay platform and clinical pathway are fit for purpose in safely and effectively ruling out IBD. A 100mg/g cut-off is optimal based on the sensitivity×specificity product. Those with significantly raised results access secondary care more quickly; direct endoscopy rates appear low but data were incomplete. Repeat tests often normalize and repeats should be mandated for all positive tests. Sensitivity drops precipitously without an appropriate age limit; educating clinical users about pretest probability should minimize false negatives, streamline test workload and reduce unnecessary clinic utilization.

Palliative long-term abdominal drains for the management of refractory ascites due to cirrhosis: a consensus document

“…Currently LTADs are not standard of care in advanced cirrhosis, ongoing concerns being community management and the increased peritonitis16 risk in cirrhosis. These concerns were evident in our national survey of BSG and BASL members 43…”