[Treatment of intractable ascites in cirrhotic patients by portal shunt].

Forty one patients with chronic liver disease and intractable ascites were treated by a portal-systemic shunt. Operative mortality was 4.8 p. 100. Ascites was definitely cleared in 97 p. 100 of the 39 survivors. Fourteen patients later developed encephalopathy which was severe in 6 (15.3 p. 100). One-year survival rate was 72 p. 100. Late deaths were mainly due to complications of liver disease. These results suggest that portal diversion is an efficient and permanent treatment of intractable ascites in cirrhotic patients. Operative mortality and overall survival rates are similar to those observed after peritoneo-venous shunting. The peritoneo-venous shunt is preferable as the first-choice treatment of intractable ascites in cirrhotics because of the risk of encephalopathy. Portal diversion should be proposed for patients with previous variceal hemorrhage and for those in whom peritoneo-venous shunt has failed.