Saphenous--peritoneal shunt in refractory ascites: a neglected technique.

Management of intractable ascites has always been a challenge. Peritoneovenous shunt (PVS) plays a major role in the surgery of intractable ascites in patients with liver cirrhosis. Positive pressure gradient between the ascitic fluid and venous pressure leading to one-way drainage of ascitic fluid into venous circulation is the mainstay. Over decades, various modifications of shunting technique have been done. Here we report our experience with this procedure which is safe, easy and effective. Here the long saphenous vein is used as a drainage system. One-way ascites flow is ensured by a natural valve in the saphenous orifice.