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[The Denver peritoneojugular shunt. Current indications].

F Bracci1, C Bracaglia, M A Zampino

  • 1Ospedale S. Giovanni Calibita-Fatebenefratelli, Isola Tiberina, Roma.

Minerva Medica
|April 1, 1989
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Summary
This summary is machine-generated.

Peritoneojugular shunts can manage intractable ascites in advanced liver cirrhosis but carry high risks. Careful patient selection and prompt management of complications like disseminated intravascular coagulation are crucial for better outcomes.

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Area of Science:

  • Hepatology
  • Surgical Gastroenterology
  • Interventional Radiology

Context:

  • Intractable ascites in advanced liver cirrhosis presents significant management challenges.
  • Peritoneojugular shunts offer a potential solution for refractory ascites.
  • This study reviews personal experience with Le Veen and Denver shunts.

Purpose:

  • To report the outcomes and complications of peritoneojugular shunts in patients with advanced liver cirrhosis.
  • To highlight the importance of patient selection and complication management.

Summary:

  • Thirty-one patients with intractable ascites underwent evaluation, with 17 receiving peritoneojugular shunts (3 Le Veen, 14 Denver).
  • High postoperative morbidity and mortality were observed, including liver failure, disseminated intravascular coagulation (DIC), hepatorenal syndrome, bleeding, sepsis, and cerebral thrombosis.
  • The study emphasizes the necessity of careful patient selection due to reinfusion morbidity and mandates prompt diagnosis and interruption of shunts in severe DIC.

Impact:

  • Findings underscore the critical need for meticulous patient selection in peritoneojugular shunt procedures.
  • Highlights the significant risks and potential complications associated with shunting for cirrhotic ascites.
  • Informs clinical practice regarding the management of ascites in advanced liver disease and the vigilance required for shunt-related complications.