Pleuroperitoneal shunt in recurrent pleural effusions.

Intractable recurrent pleural effusions remain a therapeutic problem. In most instances, instillation of a sclerosing agent into the pleural cavity does obviate the problem. However, in certain circumstances, the more drastic approach of performing a radical parietal pleurectomy must be used. The Denver peritoneovenous shunt was used in 3 patients to shunt the pleural fluids into the peritoneal cavity. In 2 patients, a complementary peritoneovenous shunt was also done. Control of intractable pleural effusion was achieved in all patients. The concept of the pleuroperitoneal shunt takes into consideration the ease of shunting the pleural fluid into the peritoneal cavity from where the fluid is readily reabsorbed by the large peritoneal surface. The shunt can be placed with the patient under local or general anesthesia.