Ascites drainage (paracentesis)

What is ascites drainage (paracentesis)?

Ascites is a build-up of fluid in the tummy (abdomen). It is most often caused by advanced liver disease such as cirrhosis, but can also be due to cancer, heart or kidney problems. As the fluid builds up, it can cause a swollen, tight, uncomfortable tummy, breathlessness and loss of appetite.

Paracentesis is the procedure of draining this fluid. A thin tube (drain or needle) is passed through the numbed skin of the abdominal wall into the fluid. A small sample can be taken to test the fluid (a diagnostic tap), or a larger volume can be drained to relieve symptoms (a therapeutic, or large-volume, paracentesis).

When a large volume is drained, you are often given a protein drip called human albumin to protect your blood pressure and kidneys. Paracentesis relieves the fluid and lets it be tested, but it does not treat the cause, so the fluid often returns and the procedure may need repeating.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Diagnostic tap versus large-volume drainage

The two are sometimes combined: fluid is sampled for testing at the same time as a larger volume is drained for relief.

Preparing for your procedure

• You will usually have blood tests beforehand to check your clotting and kidney function.
• Tell your team about blood-thinning medicines, as these may need adjusting before the procedure.
• Mention any allergies, especially to local anaesthetic or antiseptic.
• Empty your bladder before the procedure to reduce the risk of injury.
• For a planned drain, expect to be a day case and to rest afterwards; ask whether you can drive home.
• Ask whether you will be given albumin, and what it is for.
• If you have ongoing ascites, ask about treating the cause (for example a low-salt diet and water tablets) to slow fluid coming back.

What happens

You lie on a bed, usually tilted slightly, and the team checks the best spot to drain, often using ultrasound. The skin is cleaned with antiseptic and local anaesthetic is injected to numb the area, which stings briefly.

A thin tube (or needle for a diagnostic tap) is passed through the numbed abdominal wall into the fluid. For a diagnostic tap, a small sample is drawn off. For a therapeutic drain, the tube is connected to a collection bag and the fluid drains out, often over a few hours; the drain usually stays in for up to about 6 hours or until the fluid has drained to the planned amount.

If a large volume is removed, you are usually given human albumin through a drip (commonly a bottle for every few litres drained) to protect your blood pressure and kidneys. When draining is finished the tube is removed and a dressing applied.

Is this procedure right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

Comfort, sedation or contrast choices

If local anaesthetic, sedation, contrast or pain relief is used, ask what is planned, why, and what it means afterwards.

The most common minor problem is fluid leaking from the puncture site (reported in up to around 1 in 20 people). Removing a large volume can lower blood pressure and strain the kidneys, which is why albumin is given. Your clotting is checked first because of the small bleeding risk. Ask your team how much fluid they plan to remove, whether you will have albumin, and what to do if the site leaks or you feel unwell afterwards.

Published figures to discuss

Paracentesis is generally a low-risk procedure, and serious complications are uncommon, so precise rates are limited and vary with technique, the amount drained and how unwell the person is. Removing a large volume can affect blood pressure and the kidneys, which is why albumin is used. The figures below are cautious and drawn from clinical and patient-information sources.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

Recovery from the procedure itself is usually quick. The relief from draining the fluid is often felt soon afterwards, though the fluid may build up again over time because the procedure does not treat the cause.

• A flatter, more comfortable tummy soon after draining
• A small amount of fluid leaking from the site for a day or two
• Feeling tired or slightly light-headed afterwards
• The fluid gradually building up again over days to weeks if the cause persists

Aftercare

• Keep the dressing clean and dry, and follow advice on how long to leave it in place.
• If fluid leaks from the site, use the dressing as advised and report a heavy or persistent leak.
• Drink as advised and rest for the remainder of the day.
• Continue any low-salt diet and water tablets to help control fluid build-up.
• Watch for signs of infection at the site or in the fluid, and for low blood pressure (feeling faint).
• Attend any follow-up to discuss the fluid test results and treatment of the cause.
• Know who to contact if you develop fever, tummy pain or feel unwell after the procedure.

• Blood tests for clotting and kidney function done beforehand
• Blood thinners reviewed and adjusted as advised
• Bladder emptied before the procedure
• Clear plan on albumin if a large volume is to be drained
• Dressing and spare dressings for any site leak
• Arrangements to rest and, if needed, a lift home
• A contact number for problems such as fever, leak or feeling faint

Scars and how they heal

Paracentesis leaves a small puncture, not a surgical wound, so there is no significant scar. A little bruising and a small amount of fluid leak at the site are common and usually settle within a day or two. A long-term (tunnelled) drain leaves a small mark where it is sited.

⚠ Get urgent help if…

• A high temperature, shivering, or new or worsening tummy pain (possible infection of the fluid)
• Feeling very faint, dizzy or unwell after the procedure (possible low blood pressure)
• Heavy or continuous fluid or blood leaking from the site
• A rapidly swelling or very painful tummy
• Passing little or no urine, or sudden confusion or drowsiness
• Bleeding that does not stop with gentle pressure

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

Paracentesis usually gives prompt relief from a tense, uncomfortable tummy and any breathlessness from the fluid. When the fluid is tested, the results help confirm the cause and, importantly, rule infection in or out so it can be treated quickly.

It is important to understand that draining the fluid does not treat the underlying problem, whether that is liver disease, cancer, or a heart or kidney condition. The fluid commonly returns, so paracentesis is often a repeated treatment, used alongside measures aimed at the cause, such as a low-salt diet, water tablets, or treatment of the underlying disease.

How long the relief lasts depends on the cause and how well it is controlled. In ongoing liver disease or cancer the fluid often re-accumulates over days to weeks, and repeated drainage may be needed. Controlling the cause, a low-salt diet and diuretics can slow how quickly fluid returns. For persistent ascites, a long-term drain or other treatment may be considered.

Related tests, treatments or support

Ascites drainage is usually part of wider care. In liver disease it sits alongside a low-salt diet, water tablets (diuretics), and treatment of the underlying cirrhosis and portal hypertension. The fluid is often tested at the same time to check for infection. In cancer-related ascites it forms part of the overall cancer and palliative care plan.

Follow-up & long-term care

You will usually be followed up to review the fluid test results and to plan treatment of the cause and management of any further fluid. If ascites is recurrent, the team will discuss repeat drainage, optimising diuretics, or a longer-term drain, and will treat any infection found in the fluid.

• Continuing a low-salt diet and diuretics to slow fluid build-up
• Treating the underlying cause (for example liver disease) as the main way to control ascites
• Repeat drainage when fluid re-accumulates and causes symptoms
• Watching for and promptly treating infection of the fluid
• Considering a longer-term drain for persistent ascites where appropriate

Repeat, follow-on and what comes next

• Ascites commonly returns if the cause is not controlled, so drainage is often repeated.
• The amount that can be safely drained at once depends on albumin cover and your kidney function.
• For recurrent ascites, the plan may move to optimised diuretics, a long-term drain or a TIPS shunt.
• Each drainage is also an opportunity to re-check the fluid for infection.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

• Albumin cover and blood-pressure and kidney monitoring for large-volume drainage.
• Testing of the fluid for infection, with prompt antibiotics if found.
• Clear advice on the dressing, what to do if the site leaks, and warning signs of infection.
• A plan to treat the cause and to manage recurrent fluid, with results shared with your GP.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• Whether it is a quick diagnostic tap or a longer therapeutic drain
• Use of ultrasound guidance and who performs the procedure
• Human albumin given during large-volume drainage
• Blood tests beforehand and any fluid laboratory tests
• Day-case facility fees and recovery time
• How often drainage needs repeating if fluid recurs
• Treatment of the underlying cause of the ascites

• The operator's fee and the facility/day-case fee
• Whether ultrasound guidance and albumin are included
• Blood tests beforehand and laboratory testing of the fluid
• What happens, and what it costs, if the procedure needs repeating
• What happens, and what it costs, if a complication such as a leak or infection occurs
• How urgent problems are handled out of hours
• How results are shared with you and your GP, and the cancellation policy

On the NHS? Paracentesis is a routine NHS procedure when fluid build-up needs draining or testing; private care is mainly used for quicker planned appointments or choice of specialist.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a specialist safely

• Check the specialist is on the GMC Specialist Register for this area.
• Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
• You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
• Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good specialist will welcome every one of these.

• Is this a diagnostic tap, a drainage to relieve symptoms, or both?
• How much fluid do you plan to remove, and will I be given albumin?
• What is causing my ascites, and how can we slow it coming back?
• What should I do if the site leaks or I feel faint afterwards?
• Will the fluid be tested for infection, and when will I get the results?
• If the fluid keeps returning, would a long-term drain or other treatment help me?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the specialist who carries out my procedure, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this procedure not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified specialist for ascites drainage (paracentesis)

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: British Liver Trust — Cirrhosis: treatments and complications (ascites) NHS (Cambridge University Hospitals) — Paracentesis NHS (Milton Keynes University Hospital) — Large-volume paracentesis (ascites drainage) NICE NG50 — Cirrhosis in over 16s: assessment and management BSG/EASL — Spontaneous bacterial peritonitis (incidence and diagnosis) — PMC

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.