Early implantation of Denver shunt.

Abstract

The Denver peritoneovenous shunt is useful in the resolution of refractory ascites, because it alleviates symptoms and allows effective palliation. However, this shunt did not prolong the life expectancy of patients with decompensated liver cirrhosis. Therefore, when deciding whether or not to implant a Denver shunt, it is important to determine the condition of the patient with refractory ascites. Here, we determined the appropriate time for Denver shunt implantation. We retrospectively studied 21 patients who underwent Denver shunt implantation for hepatic failure-related ascites. The patients were divided into PC and WPC groups depending on whether or not paracentesis was performed before implantation of the Denver shunt, respectively. The mean interval from hospital admission to Denver shunt implantation was significantly shorter in the WPC group (9.0±2.2 days) than in the PC group (25.9±5.9 days) (p<0.0001). The mean survival time was significantly longer in the WPC group (8.4±2.5 months) (p<0.0071) than in the PC group (5.6±1.7 months). Early implantation of a Denver shunt should be considered for the treatment of ascites that is resistant to conservative medical therapy.