Table 2.

Do’s and don’ts when inserting long-term abdominal drains (LTADs) for refractory ascites

Do’s	Don’ts
Emphasise that this is a palliative intervention, the evidence being limited to a small trial and case series	Do not do routine blood tests and ascitic fluid analysis in asymptomatic patients following LTAD insertion
Ensure that patients have been referred to palliative care.	Do not routinely administer human albumin solution as an outpatient
Check haemostatic function and screen for peritonitis prior to LTAD insertion.	Do not assume that LTAD will be suitable for every patient with refractory ascites.
Provide a contact number for the hospital parent medical team.
Work closely with community nursing teams.
Ensure good nutritional intake.
Encourage caregivers to participate in home drainage.