Denver peritoneovenous shunt in the management of refractory ascites due to chronic liver diseases: impact of patients selection on its outcome

ABSTRACT

Forty four patients with refractory ascites due to chronic liver diseases that fulfilling the inclusion criteria of selection were divided into 2 groups. The first group [G1, n=24] was subdivided into 2 subgroups according to degree of liver condition; GIa [n=11] with Child-Pugh class B and GIb [n=13] with early class C. The patients were subjected to P-V shunt [Denver group]. Similarly, patients in the second group [GII, n=20] were divided into 2 subgroups GIIa [n=10] and GIIb [n=10] respectively and treated by the repeated tapping and albumin infusion [control group]. Postoperative results revealed a significant increase in urine output [P body weight [p patients fitness and satisfaction than in controls. Postoperative complications were more in GIb. Ascites recurrence occurred in 3[23%] patients in GIb due to severe infection [2 cases] and irreversible shunt obstruction [1case] and without recurrence in GIa. So, Denver P-V shunt offers a good palliation in such patients, but its use is more justified in selected cases