TITLE

Patient Selection and Survival after Peritoneovenous Shunting for Nonmalignant Ascites

AUTHOR(S)
Smith, Robert E.; Nostrant, Timothy T.; Eckhauser, Frederic E.; Wilson, Joanne P.; Knol, James A.; Strodel, William E.
PUB. DATE
August 1984
SOURCE
American Journal of Gastroenterology;Aug1984, Vol. 79 Issue 8, p659
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
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 hepatorenal syndrome, and nonrefractory but recurrent ascites. Fifty-six percent of shunting procedures were complicated by shunt malfunction and an additional 13% ended in shunt removal or ligation. Serious perioperative morbidity occurred in 47% of patients. Mean duration of shunt function was significantly less (p < 0.05) in the patients with hepatorenal syndrome (15 ± 5 days) compared to the patients with refractory ascites alone (45 ± 13 days), or the patients with nonrefractory ascites (64 ± 34 days). Mean survival was 265 ± 87 days. Survival of patients with nonrefractory ascites (767 ± 214 days) was significantly longer (p < 0.05) than that seen in patients with hepatorenal syndrome (28 ± 5 days) or in patients with refractory ascites alone (256 ± 148 days). Combined inhospital mortality was 30%. It was significantly greater (p < 0.05) in patients with hepatorenal syndrome (70%) than in patients with refractory ascites alone (14%) or in patients with nonrefractory ascites (0%). We conclude that patient selection significantly influences survival after peritoneovenous shunting and may account for the varying results reported by other groups.
ACCESSION #
16283650

 

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