EP 699 Launching a Laparoscopic Peritoneal Dialysis Catheter Service: Early Clinical Outcomes

Aims

To evaluate outcomes following laparoscopic peritoneal dialysis (PD) catheter insertion in a single-centre cohort, including catheter survival, hospital stay, complications, and subsequent patient events.

Methods

We conducted retrospective review of 17 patients undergoing laparoscopic PD catheter insertion. Data collected included catheter survival, length of hospital stay (LOS), complications graded by Clavien–Dindo classification, peritonitis rates, subsequent transplant, and mortality.

Results

Catheter survival ranged from 10 to 1194 days (mean 529; median 584). The proportion of patients remaining on PD was 76% at 6 months, 71% at 12 months, and 0% at 5 years. Mean Length of Stay was 1.06 days (range 0–3). Complications occurred in 10 patients: 2 Clavien–Dindo grade IIIb, 4 grade II, and 4 grade I. Five patients eventually developed peritonitis, corresponding to a peritonitis rate of 0.19 episodes per patient-year, below the ISPD recommended threshold (<0.5). Additional complications included 1 tunnel infection, 1 poor drainage episode, and 1 fluid overload. Only one patient was readmitted within 30 days. Six patients subsequently received a kidney transplant, and three died during follow-up.

Conclusions

Laparoscopic PD catheter insertion was associated with good medium-term catheter survival, short hospital stays, and a low peritonitis rate compared with international benchmarks.

Although complications occurred in more than half of patients, most were low-grade. The high transplant conversion rate reflects successful progression to definitive renal replacement therapy. Larger studies are required to validate these findings and refine strategies to reduce complications further.