Evaluation of portal hemodynamics in patients with refractory ascites before and after periteneo-venous shunt

ABSTRACT

Twenty patients with tense refractory ascites due to bilharzial and/or posthepatic cirrhosis [age ranged 30-60 years] were carefully selected for Denver peritoneojugular shunt [PJS] and followed up clinically and the portal vein was examined before and after shunt for evaluation of portal hemodynamics. The shunts were effective in relieving medically resistant ascites. The portal pressure increased, especially in the early postoperative period and then gradually decreased to the preoperative value. Denver peritoneovenous shunt has a higher patency rate and it is associated with fewer complications. Partial paracentesis, potent diuretics and beta blocker was recommended immediately before operation to minimize the incidence of variceal hemorrhage after shunt due to increase in portal pressure