Leveen Shunts

Twenty‐two patients with intractable malignant ascites who received a peritoneovenous shunt were studied. We found that the peritoneovenous shunt functioned longer in patients whose ascitic fluid was negative for malignant cells. The median shunt survival in alive patients in the negative cytologic group was 140 days compared to 26 days in the positive cytologic group (P = 0.01). The overall survival of these patients was poor, with a median of 32 days. Median survival of patients with positive cytologic results (26 days) was significantly worse than for the cytologically negative group (80 days; P = 0.05). The incidence of tumor emboli, confirmed at autopsy, was estimated to be about 5%. Seventy‐five percent of all complications occurred in the group of patients with a positive cytologic result. We conclude that a positive ascites fluid cytologic finding is a relative contraindication to placement of a peritoneovenous shunt since this is associated with early shunt failure, postoperative coagulopathy, infection, and tumor emboli. However, since the serious complication rate is only 4% and tumor emboli rate 5%, peritoneovenous shunting in symptomatic patients with cytologically negative malignant ascites is a useful palliative procedure.

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Selection of patients with malignant ascites for a peritoneovenous shunt

Cheung

Raaf

1982

Cancer

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Fatal pulmonary tumor embolization following peritoneovenous shunting for malignant ascites

Smith

Sternberg

Paglia

et al. 1981

Journal of Surgical Oncology

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A 44-year-old white male with pseudomyxoma peritonei and intractable malignant ascites is described. This patient underwent three peritoneovenous shunt procedures utilizing first the LeVeen shunt and finally the Denver shunt in a surgical attempt at palliative decompression of his malignant ascites. The peritoneovenous shunts resulted in massive tumor embolization to the pulmonary vasculature, clinically asymptomatic disseminated intravascular coagulation, and partial thrombosis of the superior vena cava. The pulmonary tumor embolization was manifest clinically as moderate pulmonary hypertension with increased pulmonary vascular resistance and persistent hypoxia.

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Diagnostic discriminants of thyroid cancer

Evans

1987

The American Journal of Surgery

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Leveen Shunts

Cited by 18 publications

References 4 publications

Selection of patients with malignant ascites for a peritoneovenous shunt

Selection of patients with malignant ascites for a peritoneovenous shunt

Fatal pulmonary tumor embolization following peritoneovenous shunting for malignant ascites

Diagnostic discriminants of thyroid cancer

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