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- Title
Predictive Factors for Treatment Failure after Peritoneovenous Shunt for Hepatic Ascites.
- Authors
Iida, Hiroya; Aihara, Tsukasa; Ikuta, Shinichi; Yamanaka, Naoki
- Abstract
Peritoneovenous shunt (PVS) is used to treat refractory ascites. Here, we identify predictive factors for inhospital death after PVS placement. Thirty-five patients with refractory ascites related to liver cirrhosis and/or hepatocellular carcinoma (HCC) who underwent PVS placement between February 2005 and February 2013 were included in the study. Group A comprised 13 patients for whom the PVS placement outcome was inhospital death. Group B comprised 22 patients who were discharged after PVS placement without complications. Patient background and laboratory data were analyzed to identify risk factors for inhospital death. HCC prevalence in Groups A and B was 92 and 55 per cent, respectively (P = 0.02) and that of portal venous tumor thrombus (PVTT) was 54 and 9 per cent, respectively (P = 0.003). The mean des-γ-carboxy prothrombin (DCP) level in both groups was 15,553 ± 49,330 and 787 ± 2600 mAU/mL, respectively (P = 0.009). Multivariate analysis revealed that the presence of PVTT was the only independent predictor of inhospital death (P = 0.007). The presence of PVTT, HCC, and elevated des-γ-carboxy prothrombin levels are predictors of inhospital death after PVS placement. Therefore, PVS should not be used to treat refractory ascites in patients with these predictors, particularly with PVTT.
- Subjects
ASCITES; BLOOD coagulation factors; HEPATOCELLULAR carcinoma; CIRRHOSIS of the liver; LIVER tumors; METASTASIS; PERITONEOVENOUS shunts; PROTEIN precursors; TREATMENT effectiveness; RETROSPECTIVE studies; HOSPITAL mortality
- Publication
American Surgeon, 2017, Vol 83, Issue 11, p1289
- ISSN
0003-1348
- Publication type
journal article
- DOI
10.1177/000313481708301133