Lorentzen T, Sengeløv L, Nolsøe C P, Khattar S C, Karstrup S, von der Maase H
Department of Ultrasound, Herlev Hospital, University of Copenhagen, Denmark.
Acta Radiol. 1995 Sep;36(5):481-4.
A new method for internal drainage of malignant ascites is presented in 5 patients with symptomatic malignant ascites.
US-guided percutaneous gastrostomy and paracentesis were performed using the Seldinger technique. A 2.5-mm Cope-loop catheter was inserted in the fluid-filled stomach. In the lower abdomen the proximal part of a Denver peritoneo-venous shunt was introduced after dilation up to 4.8 mm. The pump chamber was sutured to the skin. The distal part of the Denver shunt was cut a few cm from the pump chamber and connected to the gastrostomy catheter. When pumping, ascites is shunted to the stomach lumen.
The insertion presented no complications, and all shunt systems initially functioned well. However, the shunts had to be removed within the first 2 weeks because of mechanical problems such as clotting, leakage, and peritoneal septum formation. No infections were reported.
The peritoneo-gastric shunt may present a therapeutic alternative in selected patients, but the mechanical problems have first to be solved.
介绍一种针对5例有症状的恶性腹水患者进行恶性腹水内引流的新方法。
采用Seldinger技术在超声引导下进行经皮胃造瘘术和腹腔穿刺术。将一根2.5毫米的Cope环导管插入充满液体的胃内。在下腹部，将丹佛腹膜静脉分流管的近端在扩张至4.8毫米后引入。将泵腔缝合至皮肤。将丹佛分流管的远端在距泵腔几厘米处切断，并连接至胃造瘘导管。泵送时，腹水被分流至胃腔。
插管未出现并发症，所有分流系统最初功能良好。然而，由于凝血、渗漏和腹膜隔形成等机械问题，分流管不得不在头两周内拔除。未报告感染情况。
腹膜-胃分流术可能为部分患者提供一种治疗选择，但机械问题首先必须得到解决。
