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Related Experiment Videos

Peritoneovenous shunting in intractable ascites.

G T Deans, R A Spence, G W Johnston

    The Ulster Medical Journal
    |October 1, 1985
    PubMed
    Summary

    Peritoneovenous shunting effectively reduced ascites and promoted diuresis in patients with intractable ascites or malignancy. However, significant coagulation abnormalities and high mortality rates underscore its use in palliative care for refractory cases.

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    Area of Science:

    • Gastroenterology
    • Surgical Oncology
    • Nephrology

    Background:

    • Intractable ascites and malignancy pose significant challenges in patient management.
    • Peritoneovenous shunting is a potential therapeutic option for fluid management in such cases.

    Purpose of the Study:

    • To evaluate the efficacy and safety of peritoneovenous shunts in patients with intractable ascites or malignancy.
    • To assess the impact of shunting on fluid balance, coagulation parameters, and patient survival.

    Main Methods:

    • Retrospective review of fourteen patients who underwent peritoneovenous shunt insertion.
    • Analysis of ascites reduction, diuresis, weight loss, and coagulation profiles.
    • Evaluation of shunt patency, complications, and cumulative mortality.

    Main Results:

    • Complete ascites reduction, diuresis, and weight loss were observed in all patients by discharge.
    • Significant decreases in hemoglobin, packed cell volume, platelet count, and prothrombin time were noted.
    • Coagulation abnormalities occurred in 60% of patients; bleeding in 28.5%. Late shunt blockage occurred in 5 patients, less with Denver shunts.
    • One-month and one-year cumulative mortality rates were 28.5% and 78.5%, respectively.

    Conclusions:

    • Peritoneovenous shunting is effective in managing intractable ascites and malignancy-related fluid accumulation.
    • The procedure is associated with significant hematological changes and a high mortality rate, reflecting underlying disease severity.
    • Shunting should be reserved for palliative care in patients unresponsive to conventional medical therapies.

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