The peritoneo-saphenous shunt for palliation of refractory ascites.
OBJECTIVE
To describe a safe surgical technique for the management of refractory ascites.


METHODS
Two preterminal patients with respiratory compromise caused by refractory ascites had the long saphenous vein transected at mid-thigh and anastomosed to the peritoneum in the region of the internal inguinal ring. This allowed direct drainage of the ascitic fluid into the vascular system (peritoneosaphenous shunt).


RESULTS
The procedure was performed successfully on two patients. The first patient, with cirrhosis, was leading a normal lifestyle without diuretic use at 7 1/2 months' follow-up. The second patient, with cirrhosis and multifocal hepatoma, was fit enough for discharge without medication.


CONCLUSIONS
The peritoneo-saphenous shunt deserves further evaluation as a novel and safe surgical technique for the management of refractory ascites.
Gold Fields Health Services, Western Deep Levels Hospitals, Carletonville.
R S
RS
Blaylock
D
D
Emby
M
M
Hopley
J W
JW
Toogood
D001201:Ascites / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010536:Peritoneovenous Shunt; D012501:Saphenous Vein; D018608:Ultrasonography, Doppler