Peritoneovenous shunt insertion for intractable ascites: a district general hospital experience

Cardiovascular and Interventional Radiology
Fuad F HussainAnthony J Lopez

Abstract

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.

Citations

Jan 9, 2007·Cardiovascular and Interventional Radiology·Orhan OzkanOkan Akhan
Feb 6, 2007·Cardiovascular and Interventional Radiology·M J BratbyA J Lopez
Dec 31, 2010·Cardiovascular and Interventional Radiology·Shunsuke SugawaraTakahiro Tsushima
Dec 1, 2007·Seminars in Interventional Radiology·Leann S Stokes
Feb 14, 2007·Journal of Gastroenterology and Hepatology·Joo Kyung ParkYoon Jun Kim
Nov 23, 2007·Journal of Gastroenterology and Hepatology·Masahiro SeikeYoshihiro Sakai
Apr 24, 2014·Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology·Shahram AgahAbdolreza Al-Agha
Sep 13, 2013·Radiographics : a Review Publication of the Radiological Society of North America, Inc·John Martin KirbyMehran Midia
Aug 10, 2010·European Journal of Radiology·Devrim AkinciOkan Akhan
Oct 25, 2008·Journal of Vascular and Interventional Radiology : JVIR·Jong Yun WonDo Yun Lee
Oct 28, 2008·Journal of Vascular and Interventional Radiology : JVIR·Angi CourtneyGreg Gordon
Mar 15, 2006·Gastroenterology Clinics of North America·Stefanie M Rosenberg
May 9, 2014·Journal of Visceral Surgery·C SabbaghJ-M Regimbeau
Apr 29, 2021·Journal of Pediatric Gastroenterology and Nutrition·Coralie DefertChristophe Chardot

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