Document Detail


Treatment of patients with cirrhosis and refractory ascites using LeVeen shunt with titanium tip: comparison with therapeutic paracentesis.
MedLine Citation:
PMID:  7601403     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
It has recently been suggested that insertion of a titanium tip at the venous end of the LeVeen shunt drastically reduces the rate of shunt obstruction. To assess whether the LeVeen shunt with titanium tip improves the results obtained with therapeutic paracentesis, 81 patients with cirrhosis and refractory ascites were randomly assigned to therapy with paracentesis plus intravenous albumin (42 patients) or LeVeen shunt with titanium tip (39 patients). If patients were readmitted for ascites during follow-up, those in the first group were treated with paracentesis, and those in the LeVeen shunt group by the insertion of a new valve or a new shunt if obstruction was demonstrated. During first hospitalization, both treatments were equally effective in removing ascites. Complications were similar in both groups except for a higher rate of severe bacterial infection in the LeVeen shunt group. The mean duration of hospitalization was shorter in the paracentesis group than in the shunt group. During follow-up, the total number of readmissions and the number of readmissions for ascites were higher in the paracentesis group than in the shunt group (252 vs. 99, P < .001; and 193 vs. 43, P < .001, respectively). The total time in hospital, however, was similar (38 +/- 38 vs. 39 +/- 43 days, P = NS). Three patients had obstruction of the shunt during first hospitalization and 14 patients had a total of 22 obstructions during follow-up. Long-term survival was similar in both groups. The insertion of a titanium tip at the venous end of the LeVeen shunt does not prevent obstruction.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
A Ginès; R Planas; P Angeli; C Guarner; F Salerno; P Ginès; J Saló; N Rodriguez; E Domènech; G Soriano
Related Documents :
15896603 - Comparison of hemodynamics between norwood procedure and systemic-to-pulmonary artery s...
8878773 - Transjugular intrahepatic portosystemic shunts: comparison with paracentesis in patient...
12372923 - Treatment with vitamin k antagonists: frequency of indications and appropriateness of c...
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Hepatology (Baltimore, Md.)     Volume:  22     ISSN:  0270-9139     ISO Abbreviation:  Hepatology     Publication Date:  1995 Jul 
Date Detail:
Created Date:  1995-08-09     Completed Date:  1995-08-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8302946     Medline TA:  Hepatology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  124-31     Citation Subset:  IM    
Affiliation:
Department of Medicine, Hospital Clínic i Provincial, Barcelona, Spain.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Ascites / therapy*
Drainage*
Equipment Design
Female
Humans
Injections, Intravenous
Liver Cirrhosis / therapy*
Male
Middle Aged
Peritoneovenous Shunt / instrumentation*
Punctures*
Serum Albumin / therapeutic use
Titanium*
Chemical
Reg. No./Substance:
0/Serum Albumin; 7440-32-6/Titanium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Induction of sensitivity to ganciclovir in human hepatocellular carcinoma cells by adenovirus-mediat...
Next Document:  High plasma levels of atrial natriuretic peptide in preascitic cirrhosis: indirect evidence of reduc...