Indigenous cost-effective peritoneo-venous shunt for refractory ascites

Area of Science:

• Gastroenterology and Hepatology
• Surgical Innovation
• Medical Device Engineering

Background:

• Massive refractory ascites affects approximately 5% of patients with chronic liver disease.
• These patients often become unresponsive to diuretic therapy and are at risk for prerenal azotemia.
• Peritoneo-venous shunts represent a therapeutic option for select patients with refractory ascites.

Purpose of the Study:

• To evaluate the efficacy and safety of locally manufactured, single-valved peritoneo-venous shunts (GSAIMS shunts) in patients with massive refractory ascites.
• To assess shunt failure and complication rates in patients managed with GSAIMS shunts.
• To determine the impact of GSAIMS shunts on the quality of life for patients with advanced liver disease.

Main Methods:

• A study was conducted on 36 patients diagnosed with chronic liver disease and massive refractory ascites.
• Patients were managed using locally manufactured, single-valved peritoneo-venous shunts (GSAIMS shunts).
• Postoperative shunt failure and complication rates were meticulously assessed.

Main Results:

• The study demonstrated a definite improvement in the quality of life for patients treated with the GSAIMS shunt.
• The locally made shunt proved to be cost-effective.
• Careful patient selection is crucial for optimal outcomes.
• While shunt-specific data was collected, long-term follow-up was limited due to the advanced nature of liver disease in the study cohort.

Conclusions:

• Locally manufactured peritoneo-venous shunts (GSAIMS shunts) can significantly improve the quality of life in carefully selected patients with massive refractory ascites.
• The GSAIMS shunt presents a cost-effective solution with acceptable shunt failure and complication rates.
• The advanced stage of liver disease in these patients often limits the feasibility of long-term follow-up.