Peritoneovenous shunt for treatment of intractable cirrhotic ascites: an unfulfilled promise?

Peritoneovenous shunt [PVS] is widely used for the treatment of cirrhotic ascites whether intractable ascites or not. Between February 996 and August 1998, PVSs were inserted in 22 patients [14 men and 8 women] with intractable cirrhotic ascites. The mean follow up period was 20 months. All patients were non-responsive to standard medical management. Nine patients were alive and palliated, seven of them with working shunts. Thirteen patients died within the first year, five of them died with non functioning shunts. Despite palliation, complications with PVSs were high and survival was limited. This modality was recommended only in patients with cirrhotic intractable ascites not responding to standard medical or surgical management