title: Prognosis assessment of patients with refractory ascites treated with a peritoneovenous shunt.
abstract: OBJECTIVE
  We investigated the postoperative outcome and risk factors for DIC and mortality in cases of implanted PVS.
  
  
  METHODS
  We reviewed the cases of 65 patients implanted with PVS from 2000 to 2010. Of these patients, 32 were diagnosed with peritonitis carcinomatosa, 21 had liver cirrhosis with hepatocellular carcinoma (HCC), and 12 had liver cirrhosis without HCC.
  
  
  RESULTS
  The postoperative morbidity rate was 18.8%, 76.2%, and 58.3% in cases of peritonitis carcinomatosa, liver cirrhosis with HCC, and liver cirrhosis without HCC, respectively. Early death (within 7 days of surgery) was 7.7% (5/65), and the cause of death in all cases was DIC. Underlying disease, low platelet count, prolongation of prothrombin time (PT), and hyperbilirubinemia were the risk factors for development of DIC, whereas underlying disease, prolongation of PT, hypoalbuminemia, and hyperbilirubinemia were risk factors for early death. Multivariate analysis showed that liver cirrhosis with HCC and prolonged PT were the risk factors for DIC.
  
  
  CONCLUSIONS
  Patients with refractory ascites due to liver cirrhosis with HCC and those with prolonged PT should not be considered for PVS.
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Nitta
authors.forename: Shigeki
authors.initials: S
authors.lastname: Okamura
authors.forename: Takao
authors.initials: T
authors.lastname: Mizumoto
authors.forename: Hiroo
authors.initials: H
authors.lastname: Matsushita
authors.forename: Takumasa
authors.initials: T
authors.lastname: Nishimura
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Shimokawa
authors.forename: Masami
authors.initials: M
authors.lastname: Kimura
authors.forename: Hideo
authors.initials: H
authors.lastname: Baba
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001201:Ascites / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000401:mortality; D004211:Disseminated Intravascular Coagulation / Q000097:blood / Q000209:etiology* / Q000401:mortality; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000401:mortality; D008113:Liver Neoplasms / Q000150:complications / Q000401:mortality; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018579:Patient Selection; D010534:Peritoneal Neoplasms / Q000150:complications / Q000401:mortality; D010536:Peritoneovenous Shunt / Q000009:adverse effects* / Q000401:mortality; D011517:Prothrombin Time; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome