Poor outcome from peritoneovenous shunts for refractory ascites

D. G. Scholz, D. M. Nagorney, Keith Lindor

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

We reviewed in retrospect the records of all patients at our institution in whom peritoneovenous shunts were placed to manage refractory ascites due to chronic liver disease from 1977 through 1986. There was a wide spectrum of underlying liver disease in these 23 patients; most frequent was alcoholic cirrhosis. Five were in modified Child's class A, 14 were in class B, and four were in class C. Fourteen of 23 patients had some complication associated with peritoneovenous shunt placement; clinical consumptive coagulopathy, infection, and gastrointestinal hemorrhage while hospitalized were most frequent. Fifteen of 23 died, 12 while hospitalized or within 1 month of hospitalization. Death in eight patients appeared to be related to shunt placement and was due to sepsis in five, hepatorenal syndrome with an obstructed shunt in one, consumptive coagulopathy in one, and pulmonary edema in one. All modified Child's class C patients, six of seven patients with clinical consumptive coagulopathy, and all patients with a preshunt total bilirubin greater than 3.7 mg/dl died while hospitalized or within 1 month of hospitalization. This review supports studies showing that placement of peritoneovenous shunts for refractory ascites has a high morbidity and mortality in patients with advanced liver disease, and does not support their use in the management of refractory ascites.

Original languageEnglish (US)
Pages (from-to)540-543
Number of pages4
JournalAmerican Journal of Gastroenterology
Volume84
Issue number5
StatePublished - 1989
Externally publishedYes

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Peritoneovenous Shunt
Liver Diseases
Ascites
Hospitalization
Hepatorenal Syndrome
Alcoholic Liver Cirrhosis
Gastrointestinal Hemorrhage
Pulmonary Edema
Bilirubin
Sepsis
Chronic Disease
Morbidity

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Poor outcome from peritoneovenous shunts for refractory ascites. / Scholz, D. G.; Nagorney, D. M.; Lindor, Keith.

In: American Journal of Gastroenterology, Vol. 84, No. 5, 1989, p. 540-543.

Research output: Contribution to journalArticle

Scholz, D. G. ; Nagorney, D. M. ; Lindor, Keith. / Poor outcome from peritoneovenous shunts for refractory ascites. In: American Journal of Gastroenterology. 1989 ; Vol. 84, No. 5. pp. 540-543.
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