PURPOSE: A new method for internal drainage of malignant ascites is presented in 5 patients with symptomatic malignant ascites. MATERIAL AND METHODS: US-guided percutaneous gastrostomy and paracentesis were performed using the Seldinger technique. A 2.5-mm Cope-loop catheter was inserted in the fluid-filled stomach. In the lower abdomen the proximal part of a Denver peritoneo-venous shunt was introduced after dilation up to 4.8 mm. The pump chamber was sutured to the skin. The distal part of the Denver shunt was cut a few cm from the pump chamber and connected to the gastrostomy catheter. When pumping, ascites is shunted to the stomach lumen. RESULTS: The insertion presented no complications, and all shunt systems initially functioned well. However, the shunts had to be removed within the first 2 weeks because of mechanical problems such as clotting, leakage, and peritoneal septum formation. No infections were reported. CONCLUSION: The peritoneo-gastric shunt may present a therapeutic alternative in selected patients, but the mechanical problems have first to be solved.
PURPOSE: A new method for internal drainage of malignant ascites is presented in 5 patients with symptomatic malignant ascites. MATERIAL AND METHODS: US-guided percutaneous gastrostomy and paracentesis were performed using the Seldinger technique. A 2.5-mm Cope-loop catheter was inserted in the fluid-filled stomach. In the lower abdomen the proximal part of a Denver peritoneo-venous shunt was introduced after dilation up to 4.8 mm. The pump chamber was sutured to the skin. The distal part of the Denver shunt was cut a few cm from the pump chamber and connected to the gastrostomy catheter. When pumping, ascites is shunted to the stomach lumen. RESULTS: The insertion presented no complications, and all shunt systems initially functioned well. However, the shunts had to be removed within the first 2 weeks because of mechanical problems such as clotting, leakage, and peritoneal septum formation. No infections were reported. CONCLUSION: The peritoneo-gastric shunt may present a therapeutic alternative in selected patients, but the mechanical problems have first to be solved.
Authors: Rafael Romero-Castro; Victoria Alejandra Jimenez-Garcia; Jaime Boceta-Osuna; Luis Castilla-Guerra; Francisco Pellicer-Bautista; Angel Caunedo-Alvarez; Juan Manuel Herrerias-Gutierrez; Manuel Romero-Gómez; Marc Giovannini Journal: Endosc Int Open Date: 2017-10-27