Peritoneovenous Shunt Insertion for Intractable Ascites-A District General Hospital Experience Peritoneovenous Shunt for Ascites

Hussain, Fuad F.; Meer, Ziad F.; Lopez, Anthony J.
July 2004
CardioVascular & Interventional Radiology;Jul/Aug2004, Vol. 27 Issue 4, p325
Academic Journal
Ascites often contributes to patient morbidity and discomfort. When refractory to medical management, it has been managed with repeated paracentesis, implantable ports for drainage, or diversion to the urinary bladder. Peritoneovenous shunt insertion has been a technique that was traditionally performed only by surgeons but is now within the realm of interventional radiologists. Its advantage is that protein-rich ascitic fluid is returned to the intravascular compartment. This retrospective study elaborates on the successes and problems encountered during shunt insertion in our first 13 patients. Two patients are well with a functioning shunt at 14 and 32 weeks. In 6 the shunt functioned until the patients’ death from the underlying malignancy. Two required revision with variable success and in 2, shunt function could not be salvaged. There was one procedure-related mortality. Radiological insertion of these shunts is feasible and should be considered for selected patients. Options are available for assessment and salvaging of dysfunctional shunts.


Related Articles

  • Peritoneovenous Shunts for Palliation of Malignant Ascites. Mamada, Yasuhiro; Yoshida, Hiroshi; Taniai, Nobuhiko; Bandou, Kouichi; Shimizu, Tetsuya; Kakinuma, Daisuke; Mizuguchi, Yoshiaki; Ishikawa, Yoshinofi; Akimaru, Koho; Tajiri, Takashi // Journal of Nippon Medical School;2007, Vol. 74 Issue 5, p355 

    Background: Malignant ascites may produce a cluster of symptoms that include abdominal distention, early satiety, respiratory embarrassment, impaired mobility, and lethargy, and relief of these symptoms is often difficult to achieve. We report on the placement of peritoneovenous shunts (PVSs) in...

  • Identification of anastomotic leakage after colorectal surgery using microdialysis of the peritoneal cavity. Daams, F.; Wu, Z.; Cakir, H.; Karsten, T.; Lange, J. // Techniques in Coloproctology;Jan2014, Vol. 18 Issue 1, p65 

    Background: Early detection of colorectal anastomotic leakage (AL) may lead to better outcome. AL may be preceded by change in local metabolism and local ischaemia. Microdialysis of the peritoneal cavity is able to measure these changes in real-time and is minimally invasive. The aim of this...

  • Patient Selection and Survival after Peritoneovenous Shunting for Nonmalignant Ascites. Smith, Robert E.; Nostrant, Timothy T.; Eckhauser, Frederic E.; Wilson, Joanne P.; Knol, James A.; Strodel, William E. // American Journal of Gastroenterology;Aug1984, Vol. 79 Issue 8, p659 

    Patient selection and survival after peritoneovenous shunting for nonmalignant ascites was assessed in 30 patients undergoing 44 peritoneovenous shunting procedures over a 5-year period. Indications for peritoneovenous shunting included refractory ascites alone, refractory ascites complicated by...

  • A NOVEL COMPLICATION OF PERITONEOVENOUS SHUNT: CARDIAC TAMPONADE. Dulai, Gareth; Vora, Devendra; Hage, Antione; Martin, Paul // American Journal of Gastroenterology;Aug1998, Vol. 93 Issue 8, p1379 

    For the last two decades, peritoneovenous shunts (PVS) have commonly been used in the management of refractory ascites. However, these devices are associated with a wide variety of complications. We report a case of cardiac tamponade due to ventricular perforation by a PVS. Given the substantial...

  • SUPERIOR VENA CAVA THROMBOSIS SECONDARY TO PERITONEAL VENOUS SHUNTING. Bussey, H. Jane; Lowder, Webster S.; Wolma, Fred J. // Vascular Surgery;Nov/Dec1979, Vol. 13 Issue 6, p418 

    Peritoneal venous shunts are effective in providing lasting relief to patients with medically intractable ascites. Nutrition and renal function improve. Reported complications are varied. As far as we know, the complication of superior vena cava obstruction reported here has not been reported...

  • The Peritoneovenous Shunt: Expectations and Reality. Moskovitz, Morry // American Journal of Gastroenterology;Aug1990, Vol. 85 Issue 8, p917 

    Since the introduction of the LeVeen modification of the peritoneovenous shunt (PVS) in 1974, these devices have been placed in a relatively large number of patients. The most common indication has been for medically intractable ascites in the setting of chronic liver disease. A review of a...

  • Rupture and Migration of the Venous Segment of LeVeen Shunt: An Unreported Complication. Planas, Ramon; Doménech, Eugeni; Montañà, Xavier; Rodriguez, M. Pilar; Rodriguez, Nivardo; Cabré, Eduard; Gassull, Miquel Angel // American Journal of Gastroenterology;Jul1993, Vol. 88 Issue 7, p1101 

    The LeVeen peritoneovenous shunt has been used for nearly 20 yr in the treatment of refractory ascites due to liver cirrhosis. However, the technique encompasses a high incidence of serious complications. We report the case of a 59-yr-old man presenting with right pulmonary artery embolization...

  • TIPS for refractory ascites: a single-centre experience. Thalheimer, Ulrich; Leandro, Gioacchino; Samonakis, Dimitrios N.; Triantos, Christos; Senzolo, Marco; Fung, Konrad; Davies, Neil; Patch, David; Burroughs, Andrew K. // Journal of Gastroenterology;2009, Vol. 44 Issue 10, p1089 

    Transjugular intrahepatic portosystemic shunt (TIPS) has been reported superior to large-volume paracentesis for refractory ascites, but post-TIPS encephalopathy is a major complication. We intended to assess the outcome of limited diameter TIPS on ascites control, mortality, and encephalopathy...

  • PERITONEOVENOUS SHUNTING IN CIRRHOSIS: ITS ROLE IN THE MANAGEMENT OF REFRACTORY ASCITES IN THE 1990s. Wong, Florence; Blendis, Laurence // American Journal of Gastroenterology;Dec1995, Vol. 90 Issue 12, p2086 

    Discusses the use of a peritoneovenous shunt (PVS) in cirrhosis with ascites. Approaches to managing early ascites; Pathophysiology of refractory ascites formation; Advantages of using PVS; Morbidity and mortality rates of patients with insertion of PVS; Background on the study of PVS in cirrhosis.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics