COMPLICATIONS OF PERITONEOVENOUS SHUNT FOR MALIGNANT ASCITES

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  • 1 January 1980
    • journal article
    • research article
    • Vol. 64  (2-3) , 305-309
Abstract
A periotoneovenous (PV) shunt was placed in 8 patients with intractable malignant ascites. The shunt successfully controlled the ascites in 6 patients. The median survival time of the entire group was 2 mo., with 1 patient alive at 22 mo. Two of 7 patients had secondary shunt failure: 1 from an unknown cause which could not be corrected by revision and another which was corrected by revision following removal of psammoma bodies in the valve. The complications of the shunt included transient edema (4 patients), transient intravascular coagulation (4 patients), and fever (2 patients). Tumor embolization was suspected pathologically in 2 of 8 patients, although the ascitic fluid contained malignant cells in 7 or 8 patients. The PV shunt is a satisfactory palliative procedure for malignant ascites in the presence of adequate cardiac function and in the absence of urinary obstruction. The presence of bloody effusion or major intra-abdominal mass lesions contra-indicates a successful PV shunt. The acute adverse effects of the PV shunt (fever, fluid overload and fulminant disseminated intravascular coagulation) may be prevented or minimized by preoperative fluid removal to obviate a major intravascular infusion of colloid and biologically active pyrogen and thromboplastin.