LeVeen vs Denver peritoneovenous shunts for intractable @entity843 of XXXX . A randomized, prospective trial.

@entity1 @entity8 @entity82 @entity295 @entity556 @entity548 @entity75 @entity843 @entity648 @entity260 @entity1011 @entity432 @entity99
Peritoneovenous shunts (PVSs) have provided salutary effects on medically recalcitrant @entity843 , functional @entity8 , nutritional derangements, ventilatory embarrassment, and locomotion potential in @entity1 with @entity82 . While the LeVeen (LPVS) and Denver (DPVS) PVSs are most frequently implanted in such @entity1 , @entity260 of @entity548 gastroesophageal varices, @entity295 , and @entity432 occur with notable frequency. Addressing primarily the complication of PVS occlusion, a randomized prospective trial of LPVSs and DPVSs was conducted in cirrhotic @entity1 with refractory @entity843 . From July 1, 1982 to July 1, 1984, 26 initial PVSs were implanted for hepatic-related intractable @entity843 . Twenty-two @entity1 were eligible for randomization ( @entity82 , sterile @entity843 , initial PVS, total @entity648 level less than or equal to 6.0 mg/dL, @entity556 time less than or equal to 5-s prolongation, serum @entity1011 level less than or equal to 2.0 mg/dL [ @entity1011 clearance rate greater than or equal to 20 mL/min], absence of recent [less than 30 days] @entity548 gastroesophageal varices, or absent spontaneous @entity75 ). Twelve LPVSs and ten DPVSs were implanted; however, one @entity1 with a DPVS was found to have @entity99 and was excluded from analysis. All @entity1 were followed up until death or Jan 1, 1985. The PVS patency determinations included contrast shuntography, technetium Tc 99m albumin scintigraphy, sequential manual compression (DPVS), and operative or autopsy observation. Using the Kaplan-Meier actuarial analysis, the LPVS patency proved to be highly superior to that of the DPVS, while survival was not significantly different. As LPVS and DPVS complications other than patency are comparable, the LPVS is preferred for its superior patency in cirrhotic @entity1 with intractable @entity843 .
