Role of different techniques for the placement of Denver peritoneovenous shunt (PVS) in malignant ascites.
The aim of the study is to evaluate 3 different techniques of Denver peritoneovenous shunt (PVS) placement. Fifty-three patients with malignant ascites underwent placement of 55 Denver PVS by a surgical (33 cases) or percutaneous (18) or laparoscopically assisted (4) procedure. There were 2 cases of postoperative mortality due to cardiac failure, and 7 cases of shunt obstruction (2 of them required replacement). Twenty patients underwent subsequent palliative treatment with chemotherapy or surgery. Complication and control of ascites rates are similar for the 3 techniques. Placement of Denver PVS for the treatment of malignant ascites appears to be a safe and useful procedure. Surgical dissection of the jugular vein is not mandatory. The percutaneous technique is the easiest, fastest, and least invasive procedure. Laparoscopic-assisted positioning is recommended if a peritoneal biopsy and/or abdominal exploration is required for a definitive diagnosis.
Clara
Renzo
R
Service of Surgical Oncology and Biomedic Technologies, S. Giovanni Battista Antica Sede Hospital, Turin, Italy.
Righi
Dorico
D
Bortolini
Massimiliano
M
Cornaglia
Silvia
S
Ruffino
Maria Antonella
MA
Zanon
Claudio
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001201:Ascites / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010536:Peritoneovenous Shunt / Q000379:methods*; D012189:Retrospective Studies