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Role of Different Techniques for the Placement of Denver Peritoneovenous Shunt (PVS) in Malignant Ascites

2004; Lippincott Williams & Wilkins; Volume: 14; Issue: 4 Linguagem: Inglês

10.1097/01.sle.0000136675.54624.16

1534-4908

Renzo Clara, Dorico Righi, Massimiliano Bortolini, S. Cornaglia, Maria Antonella Ruffino, Claudio Zanon,

Central Venous Catheters and Hemodialysis

The aim of the study is to evaluate 3 different techniques of Denver peritoneovenous shunt (PVS) placement. Fifty-three patients with malignant ascites underwent placement of 55 Denver PVS by a surgical (33 cases) or percutaneous (18) or laparoscopically assisted (4) procedure. There were 2 cases of postoperative mortality due to cardiac failure, and 7 cases of shunt obstruction (2 of them required replacement). Twenty patients underwent subsequent palliative treatment with chemotherapy or surgery. Complication and control of ascites rates are similar for the 3 techniques. Placement of Denver PVS for the treatment of malignant ascites appears to be a safe and useful procedure. Surgical dissection of the jugular vein is not mandatory. The percutaneous technique is the easiest, fastest, and least invasive procedure. Laparoscopic-assisted positioning is recommended if a peritoneal biopsy and/or abdominal exploration is required for a definitive diagnosis.