Morbidity and mortality after peritoneovenous shunt surgery for refractory ascites.

Peritoneovenous Shunt After Failure of Octreotide Treatment for Chylous Ascites in Lymphangioleiomyomatosis

“…This therapeutic approach had been reported successfully in a few cases of LAM [2,9,10]. The risks of thrombosis or infection of the shunt in refractory ascites are well recognized [11], but to our knowledge no report mentions greater complication rates for chylous ascites. However, an obstruction of the valve occurred twice in 4 years, and it would be interesting to have a longer follow-up to appreciate the real long-term efficacy for chylous ascites and especially for LAM.…”

Peritoneovenous Shunt as a Bridge to Liver Transplantation

“…None of these adverse effects were observed in our series, probably because of a short period of PVS placement. Disseminated intra-vascular coagulation is reported to occur immediately after shunt placement in as many as 35% of patients and is thought to be due to the introduction of fibrin-rich procoagulants into the systemic circulation (13). Laboratory evidence of disseminated intra-vascular coagulation rarely leads to clinically significant bleeding, that can usually be prevented by withdrawing the majority of the ascitic fluid prior to the insertion of the PVS, together with vigilant monitoring and correction of coagulation indices (11).…”

Management of Renal Complications of Liver Disease

“…Peritoneovenous Shunts. The introduction of the peritoneovenous shunt (PVS) in 1974 allowed for continuous rather than intermittent expansion of plasma volume with ascitic fluid [34][35][36][37][38][39][40][41][42][43]. The system consists of an intraperitoneal inflow cannula, an extraperitoneal one-way valve, and a subcutaneous outflow tube, the tip of which should terminate in the right atrium (Fig 1).…”