Control of malignant ascites by peritoneovenous shunting.

Twenty peritoneovenous shunts were inserted in 17 patients with intractable malignant ascites. The ascites was controlled without the need for further paracentesis abdominis in 13 patients. Four shunts blocked and three patients had second shunts inserted, but other complications were minor. Patients who benefited from the procedure included those with macroscopically light blood staining of the ascites and those with malignant cells in the ascitic fluid. Unless the ascites is heavily blood-stained or the patient's anticipated survival is less than 1 month, peritoneovenous shunting is indicated for the treatment of uncontrollable malignant ascites.