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Related Experiment Videos

Peritoneovenous shunts palliate malignant ascites.

J A Edney1, A Hill, D Armstrong

  • 1Department of Surgery, University of Nebraska Medical Center, Omaha 68105.

American Journal of Surgery
|December 1, 1989
PubMed
Summary

Peritoneovenous shunts (PVS) effectively palliate malignant ascites in most patients, particularly those with ovarian or breast tumors. Coagulation changes indicate shunt function, but PVS is not recommended for pancreatic cancer due to poor prognosis.

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Area of Science:

  • Oncology
  • Gastroenterology
  • Surgical Innovation

Background:

  • Malignant ascites significantly impacts patient quality of life and prognosis.
  • Peritoneovenous shunts (PVS) are a palliative option for managing refractory ascites.

Purpose of the Study:

  • To evaluate the efficacy and safety of peritoneovenous shunts (PVS) for malignant ascites.
  • To assess patient survival and identify factors influencing outcomes.
  • To determine the reliability of coagulation parameters as indicators of shunt patency.

Main Methods:

  • Retrospective analysis of 55 peritoneovenous shunt (PVS) implantations (LeVeen and Denver types) in 45 patients with malignant ascites.
  • Monitoring of symptom relief, survival times, shunt revision rates, and coagulation parameters.

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  • Comparison of outcomes between different shunt types and primary tumor origins.

    • Main Results:

    • Seventy-five percent of patients experienced symptom relief from ascites.
    • Mean survival was 33 weeks, with significant variation by tumor type (e.g., ovary 71 weeks, pancreas 7 weeks).
    • All patients with functioning shunts showed coagulation alterations indicative of subclinical disseminated intravascular coagulation (DIC), serving as reliable patency indicators. Shunt revision was needed in 18%.

    Conclusions:

    • Peritoneovenous shunts (PVS) provide effective palliation for malignant ascites with acceptable morbidity, especially in ovarian and breast cancer patients.
    • Coagulation parameter alterations are reliable markers for PVS function.
    • PVS is generally not indicated for pancreatic cancer due to the short survival interval post-ascites onset.