The Effectiveness of Denver Peritoneovenous Shunt for the Treatment of Refractory Ascites

Katsufumi Miyamoto, Chyousei Kusumoto and Yasunari Kawabata

Department of Surgery, Harima Hospital of Ishikawajima-Harima Heavy Industries

Purpose: We evaluated the effectiveness of peritoneovenous shunt for refractory ascites and evaluated the usefulness of the prognostic index after peritoneovenous shunting developed by Jordi G et al Materials and methods: Subjects were 15 patients with refractory ascites undergoing peritoneovenous shunting from November 1999 to November 2003. Abdominal girth, body weight, performance status, volume of oral intake, renal function, and coagulability were evaluated pre- and postoperatively. Mean survival was calculated. The prognostic index was calculated in 9 patients based on the following equation: PI= [0.2866×Pugh score]-[0.0440×ascitic fluid protein concentration (g/l)]+[0.6926×previous spontaneous bacterial peritonitis]-[0.5656×alcoholic etiology] Results: Abdominal girth and body weight decreased significantly after shunting. Renal function significantly improved. Coagulability changed significantly after shunting. The volume of oral intake improved significantly after shunting. Performance status was not worsen by surgery. Mean survival was 165 days. Prognostic index and survival term were correlated significantly. Conclusion: Peritoneovenous shunting was useful for improving quality of life in patients with refractory ascites, and the prognostic index was useful in patient selection for peritoneovenous shunting.

Key words
refractory ascites, peritoneovenous shunt, liver cirrhosis

Reprint requests
Katsufumi Miyamoto Department of Surgery, Harima Hospital of Ishikawajima-Harima Heavy Industries
3-5-15 Asahi, Aioi, 678-0031 JAPAN

Accepted
September 28, 2005

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