[Long-term follow up after surgery for intractable ascites].

Area of Science:

• Gastroenterology and Hepatology
• Surgical Interventions
• Liver Disease Management

Context:

• Refractory ascites poses significant challenges in managing liver cirrhosis.
• Surgical interventions have been explored as alternatives to transjugular intrahepatic portosystemic shunts (TIPS) and liver transplantation.
• This study evaluates surgical outcomes over a decade.

Purpose:

• To assess the efficacy and long-term results of surgical procedures for refractory ascites.
• To identify patient subgroups that benefit most from surgical management.
• To compare surgical outcomes with the natural progression of liver disease.

Summary:

• A cohort of 24 patients with refractory ascites, primarily due to alcoholic or cryptogenic cirrhosis, underwent various surgical shunting procedures.
• Early postoperative results were excellent, with no mortality or major organ failure.
• Long-term follow-up demonstrated sustained improvement in ascites control, prevention of variceal bleeding, and encephalopathy, with most patients surviving over five years.

Impact:

• Surgical management of refractory ascites can be a beneficial option for selected patients, particularly when TIPS or transplantation are not feasible.
• This approach may improve the quality of life and reduce complications associated with advanced liver disease.
• Findings support surgical intervention as a valuable therapeutic strategy in specific clinical scenarios.