Tyden G, Samnegård H, Thulin L
Acta Chir Scand. 1982;148(7):597-600.
Ten patients with intractable ascites were treated with the LeVeen peritoneovenous shunt. Of these, three died perioperatively. Three patients with malignant ascites died within 2-3 months, but with good shunt function. In four patients, the shunt became occluded, after 2 weeks to 8 months. Percutaneous puncture of the shunt and injection of radiopaque dye revealed the occlusion t be due to thrombosis of the venous limb of the shunt. In one patient, superior vena cava thrombosis occurred. Another ten patients were treated with the Denver peritoneovenous shunt. One patient died perioperatively; four patients with malignant ascites and one with cirrhosis died after 11 days-3 months, but with good shunt function. One patient with cirrhosis is alive after 5 months, with good function. In three patients the shunt became occluded after 5 days-1 month but two of these could be cleared with the fluschchamber of the Denver shunt. It seems that the Denver shunt functions better than the LeVeen shunt, and that the primary indication for peritoneovenous shunting is malignant ascites. Here palliation is excellent. No patient developed clinical signs of disseminated intravascular coagulation following ascites infusion and in six patients where coagulation variables were studed, there were no signs of a consumption coagulopathy.
10例顽固性腹水患者接受了LeVeen腹腔静脉分流术治疗。其中，3例在围手术期死亡。3例恶性腹水患者在2至3个月内死亡，但分流功能良好。4例患者的分流管在2周至8个月后发生堵塞。经皮穿刺分流管并注入不透X线的染料显示，堵塞是由于分流管静脉段血栓形成所致。1例患者发生了上腔静脉血栓形成。另外10例患者接受了Denver腹腔静脉分流术治疗。1例患者在围手术期死亡；4例恶性腹水患者和1例肝硬化患者在11天至3个月后死亡，但分流功能良好。1例肝硬化患者在5个月后存活，功能良好。3例患者的分流管在5天至1个月后堵塞，但其中2例可通过Denver分流管的冲洗腔予以疏通。似乎Denver分流管的功能优于LeVeen分流管，腹腔静脉分流术的主要适应证是恶性腹水。在此，姑息治疗效果极佳。腹水输注后，无患者出现弥散性血管内凝血的临床症状，在6例研究了凝血指标的患者中，也没有消耗性凝血病的迹象。
