Malignant ascites. A comparison of peritoneovenous shunting and nonoperative management

BACKGROUND: Effective palliation of malignant ascites remains a difficult management problem. METHODS: Eighty-five patients with malignant ascites were studied. Forty-two patients had peritoneovenous shunts (PVS) inserted (16 LeVeen, 17 single-valve Denver, 9 double-valve Denver). RESULTS: Shunt patency was not related to the type of shunt, type of cancer, or any characteristic of the ascitic fluid. Ascites was controlled in 64% of patients with shunts and serum albumin levels were preserved. Survival and quality of life were not significantly different in comparison with those of patients treated by abdominal paracentesis. CONCLUSIONS: PVS allowed many patients to be treated successfully outside the hospital and are indicated in carefully selected cases.