Nakajima Takayoshi, Aihara Tsukasa, Ikuta Shinichi, Tomoo Yusuke, Nomura Kazunori, Matsuki Goshi, Fujikawa Masataka, Ichise Noriko, Kasai Meidai, Okamoto Ryo, Nakamoto Yoshihiko, Yanagi Hidenori, Yamanaka Naoki
Dept. of Surgery, Meiwa Hospital.
Gan To Kagaku Ryoho. 2022 Dec;49(13):1576-1578.
Hepatic ascites may cause a variety of symptoms and may progress deterioration of quality of life. Peritoneovenous shunt(PV shunt)is technically feasible and useful for the treating of refractory ascites, but sometimes it can be associated with fatal complications. This retrospective study aimed to investigate the effect of PV shunt for patients with refractory ascites, including hepatocellular carcinoma(HCC)patients.
Between January 2010 and December 2021, we retrospectively analyzed 54 consecutive patients(including 35 HCC patients)with refractory ascites who underwent PV shunt at our institute.
Body weight loss after surgery was observed in 39 of the 54 cases, and eGFR improved in 34 cases. There were 17(31.5%)in-hospital deaths. Cases with present of portal vein tumor thrombus, Child-Pugh classification C, ALBI score≥-1.12, or serum total bilirubin≥1.7 mg/dL were significantly higher in hospital-death group than in the discharged from the hospital group.
PV shunt for HCC patients with refractory ascites may be effective for improvement of renal function and symptoms. However, indications for PV shunt should be carefully considered for high-risk patients with adequate preoperative evaluation.
