Denver peritoneovenous shunting for XXXX . A prospective consecutive series.

@entity1 @entity43 @entity295 @entity82 @entity5693 @entity548 @entity5 @entity4 @entity843 @entity648 @entity177 @entity1031 @entity751 @entity1820 @entity299 @entity99 @entity7160
A Denver peritoneovenous (PV) shunt was inserted in 54 consecutive @entity1 for relief of malignant (24 @entity1 ) or cirrhotic (30) refractory ascites. The median age of both groups was 58 years, and the most frequent diagnoses were @entity43 and @entity7160 (25). Median survival time was 1.7 and 3.5 months (range, 0.1-15.5 and 0.1-50.5), and the 1-month mortality 42% and 27%, respectively. Postoperative 24-h urinary output increased by 2-31, and the 1-week weight reduction was 8 and 11 kg, respectively, compared with before shunting. @entity177 was encountered early in two @entity1 , due to catheter malposition and clotting. Four more @entity1 experienced transient failure, for an early dysfunction rate of 11%. A shunt-related operative mortality of 6% was caused by @entity4 (two @entity1 ) and @entity295 (one @entity1 ). Shunt malfunction intervened in almost half (6 of 14) of the @entity5 @entity1 surviving 1 month but was relieved in all but 1. In 3 of 22 cirrhotic 1-month survivors, the Denver shunt had to be removed owing to clotting or @entity295 (2 @entity1 ) or revised because of blockage. Seven @entity1 with @entity82 are alive a median of 18 months (range, 2-51) after PV shunt surgery. Side effects were detected in 22 @entity1 (41%): @entity1031 (9 @entity1 ), @entity295 (7), @entity548 oesophageal varices (3), @entity751 (2), postoperative @entity5693 (2), @entity843 (2), and @entity4 (2). @entity1 with @entity1820 or severe @entity299 did not benefit from the procedure. A history of @entity99 or a serum @entity648 level above about 100 mumol/l was a bad prognostic sign. We could confirm the reported considerable morbidity and mortality after PV shunting, but also its efficiency in certain cases. Careful @entity1 selection and follow-up study, timing of operation, and adherence to technical details are mandatory to improve the results.
