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Peritoneo-cystic shunt for malignant ascites.
Gynecologic Oncology
|July 1, 1984
Summary
Peritoneo-venous shunting for malignant ascites showed limited success due to poor flow. Modifications to the Denver Shunt may improve its utility in managing cancerous fluid buildup.
Area of Science:
- Oncology
- Gastroenterology
- Medical Devices
Background:
- Peritoneo-venous shunting is established for benign ascites.
- Its use in malignant ascites is limited by concerns of disease spread.
- Ovarian carcinoma patients with refractory ascites are candidates for palliative care.
Observation:
- A patient with advanced, drug-resistant ovarian cancer and massive ascites received a peritoneo-cystic shunt.
- The Denver Shunt was chosen for its miter valve and manual flow control features.
- The shunt remained patent for 5 months until the patient's death.
Findings:
- Ascites control was only fair, likely due to an insufficient pressure gradient for spontaneous flow.
- The peritoneo-cystic shunt was technically feasible and well-tolerated by the patient.
- The shunt's limited manual flow rate impacted its overall effectiveness.
Implications:
- Peritoneo-venous shunting may not be ideal for malignant ascites management in its current form.
- Device modifications to enhance manual flow rate could increase its clinical acceptability.
- Further research into shunt technology is needed for effective palliative care in advanced cancers.