[12-year experience with continuous peritoneovenous shunt in the treatment of therapy-resistant ascites and hepatorenal failure: benefits and pitfalls].
Theoretical advances using the peritoneovenous shunt were proven in clinical practice over a 12-year period of experience with this system. Continuous reinfusion of protein- and electrolyte-rich ascitic fluid improves the circulating plasma volume and seems to avoid hepatorenal syndrome. The quality of life is improved by the significant decrease in weight and ascitic volume: long-time survival seems to be improved when compared with patient groups without treatment by continuous peritoneovenous shunt. Use of the system in patients with malignant ascites does not seem to be encouraging. Fatal postoperative coagulopathy can be avoided by the administration of proteinase inhibitors. Operative mortality was 0%, hospital mortality was 23%. The system became defective in 23%, 12% caused by intra-operative technical failures.
Kreuzer
W
W
II. Chirurgische Universitätsklinik, Wien.
D001201:Ascites / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D005260:Female; D006530:Hepatorenal Syndrome / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007674:Kidney Diseases / Q000601:surgery*; D008103:Liver Cirrhosis / Q000150:complications; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications; D008297:Male; D008875:Middle Aged; D010536:Peritoneovenous Shunt / Q000009:adverse effects; D011788:Quality of Life; D013997:Time Factors
12 Jahre Erfahrung mit dem kontinuierlichen, peritoneovenösen Shunt in der Behandlung des therapieresistenten Aszites und des hepatorenalen Versagens--Nutzen und Gefahren.