[Surgical treatment of refractory ascites with peritoneovenous shunt]

Leveen and associates described a peritoneo-venous shunt which proved to be useful in patients with intractable ascites. Medical therapy, paracentesis and peritoneovenous shunt have been compared, but there is uncertainty about their relative merits. Therefore, the leveen device has be placed in last years in an increasing number of patients: it has not been shown by prospective trials to prolong survival significantly, although it may shorten hospitalization and improve the quality of life. A number of early and late complications were described but they do not influence the general results: origin and features of such complications are discussed as well as their prevention and treatment and personal cases are presented. Selection of patients and careful surgical procedure seems to be mandatory for better results.