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Peritoneovenous shunting for intractable ascites

G Tyden, H Samnegård, L Thulin

    Acta Chirurgica Scandinavica
    |January 1, 1982
    PubMed
    Summary

    The Denver peritoneovenous shunt appears more effective than the LeVeen shunt for managing intractable ascites, particularly malignant ascites, offering excellent palliation. Complications included shunt occlusion and perioperative mortality, but no disseminated intravascular coagulation was observed.

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    Area of Science:

    • Gastroenterology
    • Surgical Innovation
    • Interventional Radiology

    Background:

    • Intractable ascites poses a significant management challenge.
    • Peritoneovenous shunting offers a palliative option for fluid management.
    • Comparing different shunt devices is crucial for optimizing patient outcomes.

    Purpose of the Study:

    • To compare the efficacy and safety of the LeVeen and Denver peritoneovenous shunts.
    • To evaluate shunt function, complications, and patient survival.
    • To determine the optimal indication for peritoneovenous shunting.

    Main Methods:

    • Retrospective analysis of 20 patients with intractable ascites treated with either LeVeen or Denver peritoneovenous shunts.
    • Assessment of perioperative mortality, shunt patency, and functional duration.
    • Radiographic evaluation of shunt occlusion and clinical assessment for disseminated intravascular coagulation.

    Main Results:

    • The Denver shunt demonstrated better functional outcomes compared to the LeVeen shunt.
    • Malignant ascites showed excellent palliation with peritoneovenous shunting.
    • Shunt occlusion (thrombosis) was a significant complication for both devices.
    • No cases of disseminated intravascular coagulation or consumption coagulopathy were observed.

    Conclusions:

    • The Denver peritoneovenous shunt may offer superior performance over the LeVeen shunt.
    • Peritoneovenous shunting is a valuable palliative treatment for malignant ascites.
    • Careful patient selection and monitoring are essential to mitigate shunt-related complications.

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