Peritoneovenous Shunting as Compared with Medical Treatment in Patients with Alcoholic Cirrhosis and Massive Ascites

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Abstract
The optimal management of severe ascites in patients with alcoholic cirrhosis has not been defined. In a 5 1/2-year study, we randomly assigned 299 men with alcoholic cirrhosis, who had persistent or recurrent severe ascites despite a standard medical regimen, to receive either intensive medical treatment or peritoneovenous (LeVeen) shunting. We identified three risk groups: Group 1 had normal or mildly abnormal results on liver-function tests, Group 2 had more severe liver dysfunction or previous complications, and Group 3 had severe prerenal azotemia without kidney disease.