Evaluation of saphenoperitoneal shunt in hepatic patients with intractable ascites

ABSTRACT

Portal hypertension is a leading cause of chronic illness in Egypt. It is responsible for a significant proportion of lost days from work and refractory ascites is the most frequent admitting diagnosis in the medicine and hepatology departments. To evaluate the saphenoperitoneal shunt [SPS] in the management of hepatic patients with intractable ascites. Prospective study. Mansoura University Hospital, Department [8], General Surgery. Hepatic patients with intractable ascites. For 15 patients with intractable ascites the great saphenous vein is reversed to form saphenoperitoneal shunt under spinal anaesthesia. Patients morbidity and mortality as reflected by patients outcome, clinical follow up, laboratory follow up [kidney functions - liver functions] Child-Pugh grade and the therapeutic follow up. There was significant relief of symptoms in [86.6%] of patients, shunt stenosis in a single case and partial thrombosis in 2 cases, significant reduction of patients weight, abdominal girth and increased blood pressure, improved liver and kidney functions and upgraded patients scoring with less requirments for diuretics. The saphenoperitoneal anastomosis [SPS] has a wide range safety, cost effective, favorable outcome, less morbidity and mortality. So, it is a definitive treatment but not a palliative one