Purpose: Peritoneal dialysis (PD) catheters may be inserted surgically, blindly or by fluoroscopic approach. Adding ultrasound assistance to the fluoroscopic technique ensures entry into the abdominal cavity under direct ultrasound visualization. In this way, complications such as intestinal perforation due to puncture or damage to the superficial epigastric vessels can be significantly prevented. The aim of our study is to share our case series in which we reveal our peritoneal dialysis catheter placement technique and catheter-related complications in the post-procedure period.

Materials and methods: In this single-center study, from May 2021 to August 2023 ultrasound-fluoroscopic guided placement of PD catheters was attempted in 33 end-stage renal disease (ESRD) patients. Preoperative evaluation was performed on all patients prior to the procedure and patients were reviewed retrospectively. Short-term outcomes and complications related to treatment termination were followed.

Results: A total of 33 adult patients (19 women, 14 men; mean age 60.3) were reviewed. No complications were observed during the procedure in any patient. Two patients were started on acute peritoneal dialysis on the same day of catheter placement without any complications. The rest of the patients started peritoneal dialysis within two months of catheter placement. In terms of short-term outcomes, catheter herniation into inguinal hernia was observed in one patient (3%), hemodialysis fluid leakage to the pelvic area in two patients (6%), and catheter malfunction in one patient (3%). While the patient with herniation could continue his treatment in the next period, treatment was terminated in patients with catheter malfunction and hemodialysis fluid leakage. Apart from these, one patient whose catheter function was not impaired died due to malignancy.

Conclusion: The ultrasound assistance to fluoroscopic technique seems to be safe and effective. The short-term complication rates are encouraging; however, these results need to be validated in long-term follow-up studies.