title: Ultrasonically guided insertion of a peritoneo-gastric shunt in patients with malignant ascites.
abstract: OBJECTIVE
  A new method for internal drainage of malignant ascites is presented in 5 patients with symptomatic malignant ascites.
  
  
  METHODS
  US-guided percutaneous gastrostomy and paracentesis were performed using the Seldinger technique. A 2.5-mm Cope-loop catheter was inserted in the fluid-filled stomach. In the lower abdomen the proximal part of a Denver peritoneo-venous shunt was introduced after dilation up to 4.8 mm. The pump chamber was sutured to the skin. The distal part of the Denver shunt was cut a few cm from the pump chamber and connected to the gastrostomy catheter. When pumping, ascites is shunted to the stomach lumen.
  
  
  RESULTS
  The insertion presented no complications, and all shunt systems initially functioned well. However, the shunts had to be removed within the first 2 weeks because of mechanical problems such as clotting, leakage, and peritoneal septum formation. No infections were reported.
  
  
  CONCLUSIONS
  The peritoneo-gastric shunt may present a therapeutic alternative in selected patients, but the mechanical problems have first to be solved.
authors.affiliation: Department of Ultrasound, Herlev Hospital, University of Copenhagen, Denmark.
authors.forename: T
authors.initials: T
authors.lastname: Lorentzen
authors.forename: L
authors.initials: L
authors.lastname: Sengeløv
authors.forename: C P
authors.initials: CP
authors.lastname: Nolsøe
authors.forename: S C
authors.initials: SC
authors.lastname: Khattar
authors.forename: S
authors.initials: S
authors.lastname: Karstrup
authors.forename: H
authors.initials: H
authors.lastname: von der Maase
mesh_terms: D000714:Anastomosis, Surgical / Q000295:instrumentation / Q000379:methods; D001201:Ascites / Q000209:etiology / Q000601:surgery*; D001943:Breast Neoplasms / Q000473:pathology / Q000503:physiopathology; D002404:Catheterization; D004322:Drainage / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005774:Gastrostomy / Q000379:methods; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000503:physiopathology; D010051:Ovarian Neoplasms / Q000473:pathology / Q000503:physiopathology; D010537:Peritoneum / Q000000981:diagnostic imaging / Q000601:surgery*; D013270:Stomach / Q000000981:diagnostic imaging / Q000601:surgery*; D014463:Ultrasonography