Ascites in cirrhosis: A medical or surgical problem?
Article first published online: 6 DEC 2005
Copyright © 1990 American Association for the Study of Liver Diseases
Volume 11, Issue 2, pages 323–325, February 1990
How to Cite
Shear, L. (1990), Ascites in cirrhosis: A medical or surgical problem?. Hepatology, 11: 323–325. doi: 10.1002/hep.1840110226
- Issue published online: 6 DEC 2005
- Article first published online: 6 DEC 2005
Fifty-seven cirrhotic patients with intractable ascites had a portosystemic shunt. In 35 patients, a peritoneovenous shunt had previously failed. Forty-six patients were in Pugh's class B and 11 were in class C. There were three operative deaths (5.3%). Fifty-three (98.2%) of the 54 survivors were cleared of ascites. In one patient, ascites persisted because of postshunt heart failure that resulted in a marked increase of caval pressure. Twenty-seven patients (50%) had late encephalopathy, which was severe and disabling in 12 (22%). One-and three-year survival rates were 72% and 36%, respectively. These results suggest that although portosystemic shunts are remarkably effective in dealing with ascites, the high rate of postoperative encephalopathy is a strong argument against their routine use in the management of intractable ascites in cirrhosis.